Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 289615 | MA |
N | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | 289615 | MA |
NPI | 1013413301 |
---|---|
Provider Name | Diana Lorena Bejarano Pineda |
First Address | Boston, MA 02114-2696 |
Second Address | Boston, MA 02114-2696 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/04/2018 |
Last Update Date | 16/12/2021 |