Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207KA0200X | Allergist | 79655 | MA |
NPI | 1134286693 |
---|---|
Provider Name | Dr. Ann Wang-Dohlman |
First Address | Newton, MA 02462-1650 |
Second Address | Newton, MA 02462-1650 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/01/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
30010028 | (05) | NH |
3131122 | (05) | MA |
AW26941 | (05) | RI |
C79122 | (02) | MA |