Basic Information
Provider Information
NPI: 1831127133
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: WINSTEAD
FirstName: KAREN
MiddleName: JANE
NamePrefix: MRS.
NameSuffix:  
Credential: M.S.,O.T.R./L
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 28 MIDDLESEX ST.
Address2:  
City: QUINCY
State: MA
PostalCode: 021711019
CountryCode: US
TelephoneNumber: 6173287498
FaxNumber:  
Practice Location
Address1: 1400 VFW PKWY
Address2:  
City: WEST ROXBURY
State: MA
PostalCode: 021324927
CountryCode: US
TelephoneNumber: 6173237700
FaxNumber: 8572035680
Other Information
ProviderEnumerationDate: 06/28/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225X00000X5162MAY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist 

No ID Information.


Home