Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207SG0201X | Clinical Genetics (M.D.) | 56338 | MA |
N | 208000000X | Pediatrician | 56338 | MA |
NPI | 1689698375 |
---|---|
Provider Name | Dr. Jane E. O'brien |
First Address | Lincoln, MA 01773 |
Second Address | Brighton, MA 02135 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/07/2006 |
Last Update Date | 08/07/2007 |