Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0700X | Prosthodontist | 18802 | MA |
NPI | 1003966540 |
---|---|
Provider Name | Dr. Neda Shah-Hosseini |
First Address | Brookline, MA 02446-4602 |
Second Address | Brookline, MA 02446-4602 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/01/2007 |
Last Update Date | 08/07/2007 |