Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | 34931 | MA |
N | 2080P0210X | Pediatric Nephrologist | 34931 | MA |
NPI | 1578545521 |
---|---|
Provider Name | Dr. David Armand Link |
First Address | Cambridge, MA 02139-1047 |
Second Address | Cambridge, MA 02139-1047 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/11/2005 |
Last Update Date | 05/12/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2062976 | (05) | MA |
E02114 | (02) |