Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TH0100X | Health Service | 9918 | MA |
NPI | 1306254552 |
---|---|
Provider Name | Dr. Margaret Koepke Fox |
First Address | Belmont, MA 02478-2132 |
Second Address | Cambridge, MA 02138-5258 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/07/2014 |
Last Update Date | 31/07/2014 |