Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0205X | Pediatric Endocrinologist | 246756 | MA |
NPI | 1497912141 |
---|---|
Provider Name | Dr. Melissa K Crocker |
First Address | Boston, MA 02115-5711 |
Second Address | Boston, MA 02115-5711 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/05/2008 |
Last Update Date | 09/02/2012 |