Provider Demographics
NPI:1154596096
Name:MASTERPOL, KATHERINE S (MD)
Entity type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:S
Last Name:MASTERPOL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KATHERINE
Other - Middle Name:MARIANNE
Other - Last Name:SZYFELBEIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:83 CAMBRIDGE ST STE 1A
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:01803-4181
Mailing Address - Country:US
Mailing Address - Phone:781-272-7022
Mailing Address - Fax:781-272-8786
Practice Address - Street 1:83 CAMBRIDGE ST STE 1A
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:MA
Practice Address - Zip Code:01803-4181
Practice Address - Country:US
Practice Address - Phone:781-272-7022
Practice Address - Fax:781-272-8786
Is Sole Proprietor?:No
Enumeration Date:2008-04-22
Last Update Date:2022-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA229313207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110085121AMedicaid
MA0627101Medicare PIN