Organization
NINA CARROLL MD, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NINA M CARROLL MD (PRESIDENT)
(617) 232-0202
Entity
Organization
Contact information
Practice address
55 POND AVENUE, BROOKLINE, MA 02445
(617) 232-0202
(617) 739-7203
Mailing address
55 POND AVENUE, BROOKLINE, MA 02445
(617) 232-0202
(617) 739-7203
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
57518
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3027228
—
MA
Enumeration date
04/01/2011
Last updated
04/07/2011
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