Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | 246209 | MA |
N | 208000000X | Pediatrician | 125049414 | IL |
NPI | 1023281532 |
---|---|
Provider Name | Dr. Deborah Jean Accetta Pedersen |
First Address | Taunton, MA 02780-7393 |
Second Address | Taunton, MA 02780-7393 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/04/2008 |
Last Update Date | 12/12/2012 |