Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | 224176 | MA |
NPI | 1013994748 |
---|---|
Provider Name | Dr. John J. Homa |
First Address | Hyannis, MA 02601-3127 |
Second Address | Hyannis, MA 02601-3127 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/12/2005 |
Last Update Date | 02/11/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000031582 | BMC HEALTHNET (01) | MA |
470474 | TUFTS HEALTH PLAN (01) | MA |
AA42137 | HARVARD PILGRIM HEALTH (01) | MA |
I37144 | (02) | |
J29178 | BLUE CROSS BLUE SHIELD (01) | MA |