Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | 159458 | MA |
NPI | 1043269731 |
---|---|
Provider Name | Dr. Louis Kuchnir |
First Address | Marlborough, MA 01752-3200 |
Second Address | Marlborough, MA 01752-3200 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/05/2006 |
Last Update Date | 22/01/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H23885 | (02) |