Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | 58922 | MA |
N | 2080P0006X | Developmental - Behavioral Pediatrician | 58922 | MA |
NPI | 1003897885 |
---|---|
Provider Name | Deborah A Frank |
First Address | Boston, MA 02118-2371 |
Second Address | Boston, MA 02118-4001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/11/2005 |
Last Update Date | 05/10/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
110003114A | (05) | MA |
E03069 | (02) |