Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111NN1001X | Nutrition | 2909 | MA |
NPI | 1275699795 |
---|---|
Provider Name | Dr. Catharine Jean Guertin |
First Address | Chicopee, MA 01020-1034 |
Second Address | North Kingstown, RI 02852-1009 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/12/2006 |
Last Update Date | 17/04/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
697304 | ACN GROUP (01) | MA |
7869817 | AETNA (01) | MA |
V07207 | (02) | MA |
Y37111 | BLUE CROSS (01) | MA |