Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 60432 | MA |
N | 2080A0000X | Adolescent Medicine | 60432 | MA |
NPI | 1023081320 |
---|---|
Provider Name | Dr. Francine M Hennessey |
First Address | Charlestown, MA 02129-9142 |
Second Address | Bedford, MA 01730-2248 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/02/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3080714 | (05) | MA |
718556 | TUFTS HEALTH PLAN (01) | MA |
E95360 | (02) | |
J11477 | BCBS MA (01) | MA |