Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 270444 | MA |
NPI | 1023300670 |
---|---|
Provider Name | Dr. Elisabeth Rosl Gennis |
First Address | N Chelmsford, MA 01863-2412 |
Second Address | N Chelmsford, MA 01863-2412 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/05/2011 |
Last Update Date | 17/03/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1023300670 | NPI (01) |