Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TH0100X | Health Service | 11089 | MA |
NPI | 1104358696 |
---|---|
Provider Name | Dr. Chloe Greenbaum |
First Address | Cambridge, MA 02139-2316 |
Second Address | Cambridge, MA 02139-2316 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/04/2017 |
Last Update Date | 01/06/2020 |