# JACQUELINE STEPHEN MD LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1083099162
- **Authorized official:** DR. JACQUELINE ANTONIA STEPHEN M.D (PHYSICIAN)
- **Authorized official phone:** (617) 232-0202

## Contact information

- **Practice address:** 55 POND AVE, BROOKLINE, MA 02445-7170
- **Practice address phone:** (617) 232-0202
- **Practice address fax:** (720) 361-7739
- **Mailing address:** 1180 BEACON ST STE 3D, BROOKLINE, MA 02446-3806
- **Mailing address phone:** (617) 232-0202
- **Mailing address fax:** (720) 361-7739

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | — | NULL | Yes |
| 207V00000X | Obstetrics & Gynecology Physician | — | — | Yes |

## Other

- **Enumeration date:** 07/30/2015
- **Last updated:** 04/16/2018