Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | 0102205890 | VA |
N | 207K00000X | Allergist & Immunologist | 274443 | MA |
N | 207RA0201X | Internist - Allergy & Immunology | 274443 | MA |
NPI | 1952783151 |
---|---|
Provider Name | Dr. Ilona Dubuske |
First Address | Harvard, MA 01451-1302 |
Second Address | Arlington, VA 22203-1762 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/06/2015 |
Last Update Date | 30/09/2020 |