Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 235082 | MA |
N | 111NI0900X | Internist | 235082 | MA |
N | 207RH0000X | Hematologist | 235082 | MA |
N | 207RH0003X | Hematology & Oncology | 235082 | MA |
Y | 207RX0202X | Medical Oncology | 235082 | MA |
NPI | 1336261379 |
---|---|
Provider Name | Dr. Caron Alyce Jacobson |
First Address | Boston, MA 02215-5418 |
Second Address | Boston, MA 02215-5418 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/04/2007 |
Last Update Date | 07/06/2011 |