Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | 216587 | MA |
N | 2080P0208X | Pediatric Infectious Diseases | 216587 | MA |
NPI | 1598713687 |
---|---|
Provider Name | Dr. Jonathan B Starr |
First Address | Westwood, MA 02090 |
Second Address | Westwood, MA 02090 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/05/2006 |
Last Update Date | 04/10/2019 |