Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207P00000X | Emergency Physician | 78959 | MA |
NPI | 1003923590 |
---|---|
Provider Name | Dr. Mona Sigal |
First Address | Swampscott, MA 01907-2419 |
Second Address | Swampscott, MA 01907-2419 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/08/2006 |
Last Update Date | 17/07/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3147096 | (05) | MA |
G06914 | (02) |