Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | 2189 | MA |
Y | 222Z00000X | Podiatrist | 2189 | MA |
NPI | 1003981291 |
---|---|
Provider Name | Cynthia M Galavotti |
First Address | Hampden, MA 01036-9107 |
Second Address | Hampden, MA 01036-9107 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/11/2006 |
Last Update Date | 07/07/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U94868 | (02) |