Coolidge Corner Pediatrics LLC

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

71501 Issued in MA

Legal business name

COOLIDGE CORNER PEDIATRICS LLC

Practice address

209 Harvard St
Suite 407
Brookline, MA 02446-5071

Phone

(617) 396-8262

Fax

(617) 396-8261

NPI assigned

May 1, 2013

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Jennifer E Denton, MD

Title

Owner

Phone

(617) 396-8262

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1367366400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1367366400000",
    "number": "1437594694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "209 HARVARD ST",
            "address_2": "SUITE 407",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024465071",
            "telephone_number": "617-396-8262",
            "fax_number": "617-396-8261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 HARVARD ST",
            "address_2": "SUITE 407",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024465071",
            "telephone_number": "617-396-8262",
            "fax_number": "617-396-8261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COOLIDGE CORNER PEDIATRICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-01",
        "last_updated": "2013-05-01",
        "status": "A",
        "authorized_official_last_name": "DENTON",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "617-396-8262",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "MA",
            "license": "71501",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "71501",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kimberly L Cooke, L.I.C.S.W.
• Coolidge Corner Dental
• Coolidge Corner Eyedocs Inc
• Coolidge Corner Imaging
• Coolidge Corner Imaging, LLC
• Ilana Lindsay Cooper, PSYD
• Betty K Cooperstein, LICSW
• Leah Jane Copass, M.ED, LMHC
• Sofia Corbett
• Samuel Corman Penzel, LCSW

• Pediatrics Physician in Brookline, MA
• Providers in Brookline, MA by specialty
• Pediatrics Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.