Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TH0100X | Health Service | 9426 | MA |
NPI | 1336294164 |
---|---|
Provider Name | Dr. Amy Meade |
First Address | Belmont, MA 02478-1064 |
Second Address | Belmont, MA 02478-1064 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/01/2007 |
Last Update Date | 31/10/2011 |