Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | 213481 | MA |
NPI | 1003820317 |
---|---|
Provider Name | Dorothy J Ganick |
First Address | Manchester, MA 01944-1614 |
Second Address | Lynnfield, MA 01940-2340 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/07/2006 |
Last Update Date | 08/07/2007 |