Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 232263 | MA |
Y | 2080P0204X | Pediatric Emergency Doctor | 243724 | MA |
NPI | 1124203526 |
---|---|
Provider Name | Dr. Megan M Hannon |
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 | 03/01/2008 |
Last Update Date | 15/12/2015 |