Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | 001901 | MA |
Y | 222Z00000X | Podiatrist | 001901 | MA |
NPI | 1053491696 |
---|---|
Provider Name | Dr. Jonathan David Kaplan |
First Address | Wellesley, MA 02481-2118 |
Second Address | Wellesley, MA 02481-2118 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/10/2006 |
Last Update Date | 29/09/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
LX0453 | PTAN (01) | MA |
T87752 | (02) |