Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 79594 | MA |
Y | 208600000X | Surgeon | 79594 | MA |
N | 2086S0129X | Vascular Surgeon | 79594 | MA |
NPI | 1033191671 |
---|---|
Provider Name | Dr. Julianne Stoughton |
First Address | Stoneham, MA 02180-3660 |
Second Address | Stoneham, MA 02180-3660 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/11/2005 |
Last Update Date | 25/06/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
079594 | TUFTS HEALTH PLAN (01) | MA |
3127745 | (05) | MA |
F84163 | (02) | |
F84163 | (02) | MA |
J30769 | BCBS OF MA (01) | MA |