Basic Information
| Provider Information | |||||||||
| NPI: | 1811004963 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | KRAUSE | ||||||||
| FirstName: | DIANE | ||||||||
| MiddleName: | E | ||||||||
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| Credential: | MD, MPH | ||||||||
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| Mailing Information | |||||||||
| Address1: | 800 WASHINGTON ST | ||||||||
| Address2: | |||||||||
| City: | BOSTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 021111552 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6176365000 | ||||||||
| FaxNumber: | 6176361375 | ||||||||
| Practice Location | |||||||||
| Address1: | 800 WASHINGTON ST | ||||||||
| Address2: | |||||||||
| City: | BOSTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 021111552 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6176365000 | ||||||||
| FaxNumber: | 6176361375 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/24/2006 | ||||||||
| LastUpdateDate: | 05/12/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 05/12/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 154547 | MA | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.