Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207KA0200X | Allergist | 151493 | MA |
NPI | 1710083555 |
---|---|
Provider Name | Boris Balson |
First Address | Boston, MA 02111-1307 |
Second Address | Brighton, MA 02135-2905 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/09/2006 |
Last Update Date | 01/08/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
151493 | TUFTS (01) | MA |
21401 | NEIGHBORHOOD HEALTH PLAN (01) | MA |
3164918 | (05) | MA |
AA9876 | HARVARD PILGRIM (01) | MA |
G34612 | (02) | MA |
J17132 | BLUE CROSS BLUE SHIELD (01) | MA |