Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Y00000X | Otolaryngologist (ENT Doctor) | 274482 | MA |
Y | 207YP0228X | Pediatric Otolaryngology | 274482 | MA |
NPI | 1730509316 |
---|---|
Provider Name | Dr. Jennifer Ann Brooks |
First Address | Boston, MA 02115-5724 |
Second Address | Boston, MA 02115-5724 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/04/2014 |
Last Update Date | 20/06/2019 |