Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207N00000X | Dermatologist | MD421829 | PA |
Y | 207ND0101X | MOHS-Micrographic Surgeon | 233967 | MA |
NPI | 1144255746 |
---|---|
Provider Name | Dr. Chrysalyne D Schmults |
First Address | Brookline, MA 02445-0000 |
Second Address | Jamaica Plain, MA 02130-3446 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/07/2006 |
Last Update Date | 05/07/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0019632470001 | (05) | PA |
H88885 | (02) |