Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 254308 | MA |
Y | 2080P0214X | Pediatric Pulmonologist | 254308 | MA |
NPI | 1437474921 |
---|---|
Provider Name | Dr. Lara Christine Bishay |
First Address | Boston, MA 02115-5724 |
Second Address | Boston, MA 02115-5724 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/03/2010 |
Last Update Date | 12/04/2017 |