| Dr Stephanie Louise Koontz, MD | |
| 40 Holland St, Somerville, MA 02144-2705 | |
| (617) 629-6330 | |
| (617) 629-6128 | 
| Full Name | Dr Stephanie Louise Koontz | 
|---|---|
| Gender | Female | 
| Speciality | Obstetrics & Gynecology | 
| Location | 40 Holland St, Somerville, Massachusetts | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1225108160 | NPI | - | NPPES | 
| 2086115 | Medicaid | MA | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 207V00000X | Obstetrics & Gynecology | 220863 (Massachusetts) | Primary | 
| Entity Name | Mt Auburn Professional Services | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1992750996 PECOS PAC ID: 6103725031 Enrollment ID: O20040527001374 | 
| Mailing Address | Practice Location Address | 
|---|---|
| Dr Stephanie Louise Koontz, MD 40 Holland Street, Somerville, MA 02144 Ph: (617) 629-6330 | Dr Stephanie Louise Koontz, MD 40 Holland St, Somerville, MA 02144-2705 Ph: (617) 629-6330 | 
| Patricia M Chaudhuri, MD Obstetrics & Gynecology Medicare: Medicare Enrolled Practice Location: 230 Highland Ave, Women's Health Center, Somerville, MA 02143 Phone: 617-591-4800 | |
| Sylvia A Fine,  Obstetrics & Gynecology Medicare: Not Enrolled in Medicare Practice Location: 40 Holland St, Somerville, MA 02144 Phone: 617-629-6000 | |
| Fernando Jose Roca Vall-llobera, M.D. Obstetrics & Gynecology Medicare: Accepting Medicare Assignments Practice Location: 40 Holland St, Somerville, MA 02144 Phone: 617-629-6330 | |
| Dr. Cari Ellen Brown, M.D. Obstetrics & Gynecology Medicare: Accepting Medicare Assignments Practice Location: 40 Holland St, Somerville, MA 02144 Phone: 617-629-6330 Fax: 617-629-6128 | |
| Dr. Jocelyn A Wu, MD Obstetrics & Gynecology Medicare: Accepting Medicare Assignments Practice Location: 230 Highland Ave, Somerville, MA 02143 Phone: 617-591-4800 |