Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PE0004X | Emergency Medical Services | 22781 | MA |
NPI | 1023215696 |
---|---|
Provider Name | Dr. Howard Theodore Hermann |
First Address | Newtonville, MA 02460-2309 |
Second Address | Newtonville, MA 02460-2309 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/06/2007 |
Last Update Date | 08/07/2007 |