Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207SG0201X | Clinical Genetics (M.D.) | 80918 | MA |
NPI | 1316916372 |
---|---|
Provider Name | Dr. Jeff Mark Milunsky |
First Address | Cambridge, MA 02139-3789 |
Second Address | Cambridge, MA 02139-3789 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/03/2006 |
Last Update Date | 07/11/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3146502 | (05) | MA |
J31448 | (02) |