Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0300X | Periodontist | 15966 | MA |
NPI | 1043496219 |
---|---|
Provider Name | Dr. Neal H Fleisher |
First Address | Brookline, MA 02446-4707 |
Second Address | Brookline, MA 02446-4707 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/01/2008 |
Last Update Date | 17/01/2008 |