Provider Demographics
NPI:1538166335
Name:KIRSTEIN, RANDI J (MD)
Entity type:Individual
Prefix:
First Name:RANDI
Middle Name:J
Last Name:KIRSTEIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1 LYONS ST
Mailing Address - Street 2:
Mailing Address - City:DEDHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02026-5599
Mailing Address - Country:US
Mailing Address - Phone:781-493-3560
Mailing Address - Fax:781-326-0221
Practice Address - Street 1:1 LYONS ST
Practice Address - Street 2:
Practice Address - City:DEDHAM
Practice Address - State:MA
Practice Address - Zip Code:02026-5599
Practice Address - Country:US
Practice Address - Phone:781-493-3560
Practice Address - Fax:781-326-0221
Is Sole Proprietor?:No
Enumeration Date:2005-07-07
Last Update Date:2021-02-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA206005207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
691718OtherFIRST SENIORITY
0115690OtherMASS HEALTH
206005OtherTUFTS COMMONWEALTH
691718OtherHARVARD PILGRIM POS
691718OtherHARVARD PILGRIM PPO
206005OtherTUFTS
0024925OtherNEIGHBORHOOD HEALTH PLAN
MA0115690Medicaid
206005OtherTUFTS TOTAL HEALTH PLAN
J24337OtherBLUE SHIELD INDEMNITY
691718OtherHARVARD/PILGRIM
110225214OtherRAILROAD MEDICARE
9843292OtherCIGNA HEALTH CARE
9843292OtherHEALTHSOURCE-MA
206005OtherTUFTS BENEFIT ADMIN
27577OtherCHILDREN'S MEDICAL SECURI
MAJ16873OtherBCBS OF MA
J24337OtherBS-BLUE CARE ELECT
MAA31580Medicare ID - Type Unspecified
206005OtherTUFTS COMMONWEALTH