Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 248865 | MA |
N | 111NI0900X | Internist | 248865 | MA |
Y | 207RR0500X | Rheumatology | 248865 | MA |
N | 208000000X | Pediatrician | 248865 | MA |
N | 2080P0216X | Pediatric Rheumatologist | 248865 | MA |
NPI | 1932367562 |
---|---|
Provider Name | Dr. Jonathan Samuel Hausmann |
First Address | Boston, MA 02215-5501 |
Second Address | Boston, MA 02215-5400 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/05/2008 |
Last Update Date | 23/06/2016 |