Provider Demographics
NPI:1982609228
Name:KAROLL, DOREEN (MD)
Entity Type:Individual
Prefix:DR
First Name:DOREEN
Middle Name:
Last Name:KAROLL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:32 SOUTH ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:WALTHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02453-3555
Mailing Address - Country:US
Mailing Address - Phone:781-549-7377
Mailing Address - Fax:781-780-5688
Practice Address - Street 1:32 SOUTH ST
Practice Address - Street 2:SUITE 200
Practice Address - City:WALTHAM
Practice Address - State:MA
Practice Address - Zip Code:02453-3555
Practice Address - Country:US
Practice Address - Phone:781-549-7377
Practice Address - Fax:781-780-5688
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-14
Last Update Date:2016-12-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA737652080P0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0006XAllopathic & Osteopathic PhysiciansPediatricsDevelopmental - Behavioral Pediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3096718Medicaid