Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 229233 | MA |
Y | 2080N0001X | Neonatal-Perinatal Doctor | 229233 | MA |
N | 2080P0006X | Developmental - Behavioral Pediatrician | 229233 | MA |
NPI | 1114959657 |
---|---|
Provider Name | Bradlee G Drabant |
First Address | Boston, MA 02241-5348 |
Second Address | Worcester, MA 01655-0002 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/07/2006 |
Last Update Date | 03/05/2011 |