Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | 214055 | MA |
N | 207R00000X | Internist | 214055 | MA |
N | 111NI0900X | Internist | 214055 | MA |
NPI | 1063495562 |
---|---|
Provider Name | Dr. Aleena Banerji |
First Address | Charlestown, MA 02129-9142 |
Second Address | Boston, MA 02114-3117 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/11/2005 |
Last Update Date | 29/07/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0174301 | (05) | MA |
214055 | TUFTS HEALTH PLAN (01) | MA |
H67196 | (02) | |
J25223 | BCBS MA (01) | MA |