Provider Demographics
NPI:1144254053
Name:KLEIN, JOHANNA H (MD)
Entity type:Individual
Prefix:
First Name:JOHANNA
Middle Name:H
Last Name:KLEIN
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 1:1101 BEACON ST STE 2W
Mailing Address - Street 2:
Mailing Address - City:BROOKLINE
Mailing Address - State:MA
Mailing Address - Zip Code:02446-5587
Mailing Address - Country:US
Mailing Address - Phone:617-731-2000
Mailing Address - Fax:617-731-2001
Practice Address - Street 1:1101 BEACON ST STE 2W
Practice Address - Street 2:
Practice Address - City:BROOKLINE
Practice Address - State:MA
Practice Address - Zip Code:02446-5587
Practice Address - Country:US
Practice Address - Phone:617-731-2000
Practice Address - Fax:617-731-2001
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2020-01-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA153948207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine