Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080N0001X | Neonatal-Perinatal Doctor | 266167 | MA |
NPI | 1023376522 |
---|---|
Provider Name | Dr. Cicely Williams Fadel |
First Address | Boston, MA 02215-5400 |
Second Address | Boston, MA 02215-5400 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/05/2012 |
Last Update Date | 29/08/2019 |