Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | 216176 | MA |
N | 2080P0203X | Pediatric Critical Care Doctor | 216176 | MA |
NPI | 1104927623 |
---|---|
Provider Name | Dr. Phoebe Hildreth Yager |
First Address | Charlestown, MA 02129-9142 |
Second Address | Boston, MA 02114-2696 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/09/2006 |
Last Update Date | 24/11/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2012316 | (05) | MA |
216176 | TUFTS HEALTH PLAN (01) | MA |
H89600 | (02) | |
J26342 | BCBS MA (01) | MA |