Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 217233 | MA |
N | 2084N0400X | Neurologist | 217233 | MA |
Y | 2084N0402X | Child Neurologist | 217233 | MA |
NPI | 1295718625 |
---|---|
Provider Name | Dr. Lauren Lafortune |
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 | 21/11/2005 |
Last Update Date | 01/10/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H85921 | (02) |