Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | LP01770 | RI |
N | 2080P0207X | Pediatric Hematology-Oncologist | 250383 | MA |
Y | 2080P0207X | Pediatric Hematology-Oncologist | 56414 | CT |
NPI | 1093943276 |
---|---|
Provider Name | Dr. Natasha Nichole Frederick |
First Address | Boston, MA 02115-5724 |
Second Address | Hartford, CT 06106-3322 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/06/2009 |
Last Update Date | 16/01/2019 |