Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0402X | Child Neurologist | 272049 | MA |
NPI | 1386164101 |
---|---|
Provider Name | Ashley Weng |
First Address | Woburn, MA 01801-6966 |
Second Address | Boston, MA 02111 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/06/2017 |
Last Update Date | 18/06/2018 |