Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 233329 | MA |
N | 207XX0005X | Sports Medicine Orthopaedic Surgeon | 233329 | MA |
NPI | 1184773996 |
---|---|
Provider Name | Amy Abbot |
First Address | Boston, MA 02241-0001 |
Second Address | Milford, MA 01757-3005 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/01/2007 |
Last Update Date | 21/07/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2147882 | (05) | MA |