Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | MD428754 | PA |
N | 2080P0205X | Pediatric Endocrinologist | 036.130664 | IL |
Y | 2080P0205X | Pediatric Endocrinologist | 269242 | MA |
NPI | 1477754687 |
---|---|
Provider Name | Dr. Dorit Koren |
First Address | Boston, MA 02114-2621 |
Second Address | Boston, MA 02114-2621 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/05/2007 |
Last Update Date | 20/12/2016 |