Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RN0300X | Nephrologist | 70501 | MA |
NPI | 1023056397 |
---|---|
Provider Name | Alice M Sheridan |
First Address | Boston, MA 02115-6105 |
Second Address | Boston, MA 02115-5727 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/06/2006 |
Last Update Date | 01/10/2019 |