Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0003X | Hematology & Oncology | 216716 | MA |
NPI | 1033156708 |
---|---|
Provider Name | Bita Tabesh |
First Address | Boston, MA 02215-3904 |
Second Address | Boston, MA 02215-3904 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/06/2006 |
Last Update Date | 05/03/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2022010 | (05) | MA |