DR. CHRISTINE ANNE DIEDWARDO (NPI# 1164479705) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164479705 |
| Entity Type | Individual |
| Full Name | DR. CHRISTINE ANNE DIEDWARDO |
| Credential | M.D. |
| Practice Address |
41 Mall Rd Burlington MA 01805-0001 |
| Practice Telephone | 7817445100 |
| Practice Fax Number | 7817445215 |
| Mailing Telephone | 7817445100 |
| Mailing Fax Number | 7817445215 |
| Enumeration Date | 2006-05-28 |
| Last Update Date | 2010-10-29 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208200000X | Plastic Surgery | 204888 | MA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MA | 0151246 | 05 | |
| MA | 110004228A | 05 |
| Street Address |
41 MALL RD |
| City | BURLINGTON |
| State | MA |
| Zip Code | 01805-0001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770588923 | Gene Wong | Radiology | 41 Mall Rd, Burlington, MA 01805 | 2005-06-15 |
| 1689289977 | Justin Li | Student in an Organized Health Care Education/Training Program | 41 Mall Rd, Burlington, MA 01805-0001 | 2020-09-13 |
| 1235743741 | Rebecca C Mccarthy | Registered Nurse | 41 Mall Rd, Burlington, MA 01805-0001 | 2020-09-02 |
| 1730791419 | Jason Lefkowitz | Student in an Organized Health Care Education/Training Program | 41 Mall Rd, Burlington, MA 01805-0001 | 2020-08-23 |
| 1235749185 | Jing Lun James Xu | Student in an Organized Health Care Education/Training Program | 41 Mall Rd, Burlington, MA 01805-0001 | 2020-08-05 |
| 1841808482 | Evgeny Romanov | Student in an Organized Health Care Education/Training Program | 41 Mall Rd, Burlington, MA 01805-0001 | 2020-07-20 |
| 1780201319 | Nicole Emily Arsenault | Nurse Practitioner | 41 Mall Rd, Burlington, MA 01805-0001 | 2020-06-30 |
| 1841817590 | Joseph Clinton Mccabe | Student in an Organized Health Care Education/Training Program | 41 Mall Rd, Burlington, MA 01805-0001 | 2020-06-29 |
| 1730706508 | Hina Bhat | Student in an Organized Health Care Education/Training Program | 41 Mall Rd, Burlington, MA 01805-0001 | 2020-06-28 |
| 1902423734 | Jonathan Tong Xu | Student in an Organized Health Care Education/Training Program | 41 Mall Rd, Burlington, MA 01805-0001 | 2020-06-27 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750867909 | Natalie Teresa Dal'bo | Student in an Organized Health Care Education/Training Program | 41 Mall Road Office of Graduate Medical Education, Burlington, MA 01805 | 2018-07-11 |
| 1043710791 | Beth Israel Lahey Health Primary Care, Inc. | Urology | Lahey Institute of Urology, Beverly, 41 Mall Rd., Burlington, MA 01805 | 2018-02-20 |
| 1902240872 | Lloyd Jones Jr. | Student in an Organized Health Care Education/Training Program | 41 Mall Rd Department of Plastic Surgery, Burlington, MA 01805 | 2013-04-23 |
| 1508020470 | Russell Andrew Baur | Internal Medicine | Lahey Clinic Inc., 41 Mall Road, Burlington, MA 01805 | 2008-07-10 |
| 1356491237 | Jacob Magee Sands | Internal Medicine | 41 Burlington Mall Rd., Lahey Clinic, Burlington, MA 01805 | 2007-01-11 |
| 1588757108 | Richard Alan Wold | Nurse Anesthetist, Certified Registered | Lahey Clinic Medical Center, 41 Mall Road, Burlington, MA 01805 | 2006-10-02 |
| 1841302387 | David M. Venesy | Internal Medicine | Lahey Clinic Cardiology -5 E, 41 Mall Road, Burlington, MA 01805 | 2006-08-31 |
| 1790750354 | Cara J. Foss | Nurse Practitioner | Lahey Hospital and Medical Center, 41 Mall Road, Burlington, MA 01805 | 2006-02-17 |
| 1750376380 | Darryl D Esakof | Internal Medicine | 41 Mall Road, Department of Cardiovascular Medicine, Lahey Clinic, Burlington, MA 01805 | 2005-09-20 |
| 1225022155 | Laura Saluja | Internal Medicine | Lahey Clinic - General Internal Medicine, 41 Mall Road, Burlington, MA 01805 | 2005-09-07 |
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| Taxonomy Code | 208200000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Plastic Surgery |
| A plastic surgeon deals with the repair, reconstruction or replacement of physical defects of form or function involving the skin, musculoskeletal system, craniomaxillofacial structures, hand, extremities, breast and trunk and external genitalia or cosmetic enhancement of these areas of the body. Cosmetic surgery is an essential component of plastic surgery. The plastic surgeon uses cosmetic surgical principles to both improve overall appearance and to optimize the outcome of reconstructive procedures. The surgeon uses aesthetic surgical principles not only to improve undesirable qualities of normal structures but in all reconstructive procedures as well. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Plastic Surgery, 2007. http://www.abplsurg.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Plastic Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497898142 | Victor K Au | Plastic Surgery | 2272 Lakeview Terrace, Burlington, NC 27215 | 2007-02-14 |
| 1043530819 | Thomas Willson | Plastic Surgery | 111 Colchester Ave, Burlington, VT 05401 | 2010-06-03 |
| 1528086071 | David Bryan | Plastic Surgery | Lahey Clinic, 41 Mall Rd, Burlington, MA 01805-0001 | 2006-07-17 |
| 1023059631 | Sonal N. Pandya | Plastic Surgery | 41 Mall Rd, Burlington, MA 01805-0001 | 2006-06-08 |
| 1134188659 | Adam James Vernadakis | Plastic Surgery | 41 Mall Rd, Lahey Clinic, Inc. - Plastic Surgery, Burlington, MA 01805-0001 | 2006-03-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568083285 | Hpss-wpho, Inc | Plastic Surgery | 92 Montvale Ave Ste 3300, Stoneham, MA 02180-3652 | 2020-05-05 |
| 1134762693 | Clareo Aesthetics | Plastic Surgery | 25 Boylston St Ste 304, Chestnut Hill, MA 02467-1710 | 2019-10-28 |
| 1407375454 | Michael Kutka Md Inc | Plastic Surgery | 62 Brown St Ste 206, Haverhill, MA 01830-6790 | 2017-09-11 |
| 1881119378 | Taylor Jan Berube | Plastic Surgery | 300 Stafford St Ste 256, Springfield, MA 01104-3513 | 2017-08-07 |
| 1700299245 | Greater Boston Plastic Surgery & Luxe Aesthetics | Plastic Surgery | 10 Roseberry Dr, Boylston, MA 01505-2024 | 2014-06-03 |
| 1831510528 | Aesthetic Plastic Surgery of North Shore PC | Plastic Surgery | 29 Hickory Hill Rd, Manchester, MA 01944-1575 | 2013-12-23 |
| 1881036903 | Richard V. Montilla M.d, P.C. | Plastic Surgery | 123 Summer St Ste 675, Worcester, MA 01608-1216 | 2013-07-18 |
| 1346551199 | Aparajit Naram | Plastic Surgery | 2 Medical Center Dr Ste 206, Springfield, MA 01107-1272 | 2010-06-27 |
| 1508182296 | Jonathan Y Lee | Plastic Surgery | 2 Medical Center Dr Ste 309, Springfield, MA 01107-1271 | 2010-04-20 |
| 1598907420 | Ryan Patrick Cauley | Plastic Surgery | 110 Francis St Ste 5a, Boston, MA 02215 | 2009-03-24 |
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| City | BURLINGTON |
| Zip Code | 01805 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.