Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0203X | Pediatric Critical Care Doctor | 257130 | MA |
NPI | 1124223029 |
---|---|
Provider Name | Dr. Kimberly Lynn Marohn |
First Address | Springfield, MA 01199-1619 |
Second Address | Springfield, MA 01199-1619 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/06/2007 |
Last Update Date | 21/02/2015 |