Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0400X | Neurologist | 74328 | MA |
NPI | 1013908540 |
---|---|
Provider Name | Dr. Anne Buckingham Young |
First Address | Charlestown, MA 02129-9142 |
Second Address | Boston, MA 02114-3117 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/11/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
074328 | TUFTS HEALTH PLAN (01) | MA |
3082172 | (05) | MA |
E25539 | (02) | |
J11511 | BCBS MA (01) | MA |