Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 204300 | MA |
Y | 2080P0205X | Pediatric Endocrinologist | 204300 | MA |
NPI | 1447329438 |
---|---|
Provider Name | Dr. Alexandra L Haagensen |
First Address | Weston, MA 02493-1421 |
Second Address | Boston, MA 02115-5724 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/11/2006 |
Last Update Date | 09/05/2014 |