Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0205X | Pediatric Endocrinologist | 234486 | MA |
NPI | 1316130941 |
---|---|
Provider Name | Dr. Ksenia N Tonyushkina |
First Address | Springfield, MA 01199-1001 |
Second Address | Springfield, MA 01107-1274 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/08/2007 |
Last Update Date | 16/01/2019 |