Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 35559 | MA |
N | 2080P0210X | Pediatric Nephrologist | 35559 | MA |
NPI | 1801887252 |
---|---|
Provider Name | Dr. Julie R Ingelfinger |
First Address | Charlestown, MA 02129-9142 |
Second Address | Boston, MA 02114 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/11/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2012715 | (05) | MA |
724010 | TUFTS HEALTH PLAN (01) | MA |
D88885 | (02) | |
M08503 | BCBS MA (01) | MA |