Provider Demographics
NPI:1720078033
Name:RAUCH, PAULA KAREN (MD)
Entity Type:Individual
Prefix:DR
First Name:PAULA
Middle Name:KAREN
Last Name:RAUCH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 9142
Mailing Address - Street 2:MASS GENERAL PHYSICIAN ORGANIZATION
Mailing Address - City:CHARLESTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:02129-9142
Mailing Address - Country:US
Mailing Address - Phone:617-724-5600
Mailing Address - Fax:617-726-5567
Practice Address - Street 1:55 FRUIT ST
Practice Address - Street 2:YAW 6900
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-2621
Practice Address - Country:US
Practice Address - Phone:617-724-3923
Practice Address - Fax:617-726-5567
Is Sole Proprietor?:No
Enumeration Date:2005-10-27
Last Update Date:2012-07-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA513032084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA724839OtherTUFTS HEALTH PLAN
MA3045625Medicaid
MAJ02925OtherBCBS MA
MA724839OtherTUFTS HEALTH PLAN
MAJ02925Medicare ID - Type Unspecified