Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0001X | Clinical Cardiac Electrophysiologist | 265916 | MA |
N | 2080P0202X | Pediatric Cardiologist | 265916 | MA |
N | 2080P0202X | Pediatric Cardiologist | MD24203 | ME |
NPI | 1285977082 |
---|---|
Provider Name | Dr. Edward T O'leary |
First Address | Boston, MA 02115-5724 |
Second Address | Boston, MA 02115-5724 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/03/2013 |
Last Update Date | 08/02/2021 |