Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207VE0102X | Reproductive Endocrinologist | 015833 | ME |
N | 207VE0102X | Reproductive Endocrinologist | 272983 | NY |
Y | 207VE0102X | Reproductive Endocrinologist | 58565 | MA |
N | 207VE0102X | Reproductive Endocrinologist | MD11056 | RI |
N | 207VG0400X | Gynecologist | 015833 | ME |
N | 207VG0400X | Gynecologist | 58565 | MA |
N | 207VG0400X | Gynecologist | MD11056 | RI |
NPI | 1497701866 |
---|---|
Provider Name | Dr. Alan Stewart Penzias |
First Address | Waltham, MA 02451-1100 |
Second Address | Waltham, MA 02451 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/05/2006 |
Last Update Date | 22/05/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3095011 | (05) | MA |
E57934 | (02) | MA |