Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 238782 | MA |
Y | 2080P0207X | Pediatric Hematology-Oncologist | 238782 | MA |
NPI | 1083898373 |
---|---|
Provider Name | Dr. Andrew E Place |
First Address | Boston, MA 02115-5724 |
Second Address | Boston, MA 02115-5724 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/12/2007 |
Last Update Date | 10/12/2011 |