Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 270621 | MA |
Y | 2080P0208X | Pediatric Infectious Diseases | 270621 | MA |
NPI | 1053738344 |
---|---|
Provider Name | Dr. Marguerite Indriati Hood Pishchany |
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 | 25/03/2014 |
Last Update Date | 14/12/2019 |