Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RE0101X | Endocrinologist (Diabetes Doctor) | 283645 | MA |
NPI | 1043605058 |
---|---|
Provider Name | Dr. Ariana Patrice Cannavo |
First Address | Boston, MA 02130-4817 |
Second Address | Boston, MA 02130-4817 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/04/2015 |
Last Update Date | 17/11/2020 |