Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0106X | Oral and Maxillofacial Pathology | 14278 | MA |
NPI | 1255441804 |
---|---|
Provider Name | Dr. Sadru P Kabani |
First Address | Boston, MA 02118-2308 |
Second Address | Boston, MA 02118-2308 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/08/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0806005 | (05) | MA |
25443 | FALLON COMM HEALTH (01) | |
3068028 | AETNA (01) | |
711511 | TUFTS HEALTH PLAN (01) | |
8000239 | UNITED HEALTH (01) | |
AA1699 | HARVARD PILGRIM (01) | |
U28280 | (02) |