Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | 226970 | NY |
N | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | 226970-1 | NY |
Y | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | 272611 | MA |
NPI | 1063464915 |
---|---|
Provider Name | Alexandra C Spadola |
First Address | Boston, MA 02111-1552 |
Second Address | Boston, MA 02111-1552 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/05/2006 |
Last Update Date | 17/03/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02773059 | (05) | NY |