Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0214X | Pediatric Pulmonologist | 43969 | MA |
NPI | 1427048107 |
---|---|
Provider Name | Dr. Henry Lawrence Dorkin |
First Address | Boston, MA 02115 |
Second Address | Boston, MA 02115-5724 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/10/2005 |
Last Update Date | 25/09/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0131083 | (05) | MA |
043969 | TUFTS HEALTH PLAN (01) | MA |
D88129 | (02) | |
E05370 | BCBS MA (01) | MA |