Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 219379 | MA |
N | 2080P0208X | Pediatric Infectious Diseases | 219379 | MA |
NPI | 1639110075 |
---|---|
Provider Name | Dania Moh Ghaleb Ali-Ahmad |
First Address | Chestnut Hill, MA 02467-1715 |
Second Address | Chestnut Hill, MA 02467-1715 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/06/2006 |
Last Update Date | 08/07/2007 |