Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 4301093163 | MI |
Y | 2080P0205X | Pediatric Endocrinologist | 246955 | MA |
NPI | 1174777395 |
---|---|
Provider Name | Charumathi Baskaran |
First Address | Boston, MA 02115-5711 |
Second Address | Boston, MA 02115-5711 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/11/2008 |
Last Update Date | 04/12/2017 |