Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207U00000X | Nuclear Medicine Specialist | 48401 | MA |
NPI | 1588654198 |
---|---|
Provider Name | Dr. Carlos Alberto Rabito |
First Address | Charlestown, MA 02129-9142 |
Second Address | Boston, MA 02114-2696 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/10/2005 |
Last Update Date | 09/08/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
6195113 | (05) | MA |
725100 | TUFTS (01) | MA |
A66350 | (02) | |
J04564 | BCBS MA (01) | MA |