Provider Demographics
NPI:1548889090
Name:KLIBANOFF-DOMBROWSKI, KAITLYN A (DO)
Entity type:Individual
Prefix:DR
First Name:KAITLYN
Middle Name:A
Last Name:KLIBANOFF-DOMBROWSKI
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:KAITLIN
Other - Middle Name:A
Other - Last Name:DOMBROWSKI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DO
Mailing Address - Street 1:200 MILL RD STE 180
Mailing Address - Street 2:
Mailing Address - City:FAIRHAVEN
Mailing Address - State:MA
Mailing Address - Zip Code:02719-5255
Mailing Address - Country:US
Mailing Address - Phone:508-973-2000
Mailing Address - Fax:508-973-2001
Practice Address - Street 1:101 PAGE ST
Practice Address - Street 2:
Practice Address - City:NEW BEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02740-3464
Practice Address - Country:US
Practice Address - Phone:508-973-5919
Practice Address - Fax:508-973-5918
Is Sole Proprietor?:No
Enumeration Date:2020-04-14
Last Update Date:2025-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1014975208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist