Provider Demographics
NPI:1215907092
Name:MEISINGER, KIRSTEN (MD)
Entity type:Individual
Prefix:DR
First Name:KIRSTEN
Middle Name:
Last Name:MEISINGER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:337 SOMERVILLE AVE
Mailing Address - Street 2:
Mailing Address - City:SOMERVILLE
Mailing Address - State:MA
Mailing Address - Zip Code:02143-2914
Mailing Address - Country:US
Mailing Address - Phone:617-665-3370
Mailing Address - Fax:617-628-1288
Practice Address - Street 1:337 SOMERVILLE AVE
Practice Address - Street 2:UNION SQUARE FAMILY HEALTH CENTER
Practice Address - City:SOMERVILLE
Practice Address - State:MA
Practice Address - Zip Code:02143-2914
Practice Address - Country:US
Practice Address - Phone:617-665-3370
Practice Address - Fax:617-625-1288
Is Sole Proprietor?:No
Enumeration Date:2006-01-25
Last Update Date:2011-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA158761207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3202542Medicaid
MAH02444Medicare UPIN
MAA30123Medicare ID - Type Unspecified