Provider Demographics
NPI:1194732107
Name:ENGLENDER, CAROL SUE (MD)
Entity type:Individual
Prefix:
First Name:CAROL
Middle Name:SUE
Last Name:ENGLENDER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:160 SPEEN STREET
Mailing Address - Street 2:SUITE 203
Mailing Address - City:FRAMINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:01701
Mailing Address - Country:US
Mailing Address - Phone:508-875-0875
Mailing Address - Fax:508-875-0005
Practice Address - Street 1:160 SPEEN STREET
Practice Address - Street 2:SUITE 203
Practice Address - City:FRAMINGHAM
Practice Address - State:MA
Practice Address - Zip Code:01701
Practice Address - Country:US
Practice Address - Phone:508-875-0875
Practice Address - Fax:508-875-0005
Is Sole Proprietor?:No
Enumeration Date:2006-08-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA46241207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
B336NOtherBCBS
B336NOtherBCBS