Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0400X | Neurologist | 76360 | MA |
N | 2084N0600X | Clinical Neurophysiologist | 76360 | MA |
NPI | 1043201502 |
---|---|
Provider Name | Dr. Andrew James Cole |
First Address | Charlestown, MA 02129-9142 |
Second Address | Boston, MA 02114-2621 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/11/2005 |
Last Update Date | 01/08/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
076360 | TUFTS HEALTH PLAN (01) | MA |
3096769 | (05) | MA |
E39427 | (02) | |
J12895 | BCBS MA (01) | MA |