Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0131X | Foot Surgery | 2493 | MA |
NPI | 1174050637 |
---|---|
Provider Name | Catherine Jacobs |
First Address | Chestnut Hill, MA 02467-2115 |
Second Address | Hartford, CT 06105-1208 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/05/2017 |
Last Update Date | 03/02/2021 |