Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PP0204X | Pediatric Emergency Physician | MD073706L | PA |
N | 208000000X | Pediatrician | MD073706L | PA |
N | 2080P0204X | Pediatric Emergency Doctor | 79662 | MA |
NPI | 1447241898 |
---|---|
Provider Name | Dr. Pegeen W Eslami |
First Address | Boston, MA 02241-0001 |
Second Address | Pittsburgh, PA 15224 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/11/2005 |
Last Update Date | 03/08/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3152383 | (05) | MA |
G44018 | (02) | MA |