Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 230777 | MA |
Y | 2080P0210X | Pediatric Nephrologist | 230777 | MA |
NPI | 1922141316 |
---|---|
Provider Name | Deborah R Stein |
First Address | Boston, MA 02115-5724 |
Second Address | Boston, MA 02115-5724 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/02/2007 |
Last Update Date | 28/08/2012 |