Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207K00000X | Allergist & Immunologist | 216812 | MA |
Y | 2080P0201X | Pediatric Allergist | 216812 | MA |
NPI | 1518931609 |
---|---|
Provider Name | Dr. Andrew J Macginnitie |
First Address | Boston, MA 02115 |
Second Address | Boston, MA 02115 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/02/2006 |
Last Update Date | 16/09/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
100937488 | (05) | PA |
I04821 | (02) | PA |