Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 231124 | MA |
Y | 2084N0402X | Child Neurologist | 231124 | MA |
NPI | 1336357615 |
---|---|
Provider Name | Dr. Kerri Lynn Larovere |
First Address | Andover, MA 01810-5880 |
Second Address | Boston, MA 02115-5724 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/05/2007 |
Last Update Date | 05/07/2012 |