Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RH0000X | Hematologist | 48905 | MA |
NPI | 1295708642 |
---|---|
Provider Name | Dr. Carl J. O'hara |
First Address | Boston, MA 02118 |
Second Address | Boston, MA 02118-2646 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/02/2006 |
Last Update Date | 27/09/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
110064038A | (05) | MA |
A56666 | (02) | MA |