Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | 847 | PR |
NPI | 1053373647 |
---|---|
Provider Name | Daina Toca Cruz |
First Address | Weymouth, MA 02190-2606 |
Second Address | Weymouth, MA 02190-2606 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/04/2006 |
Last Update Date | 19/08/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
9522 | MA- OT LICENSED (01) | MA |