Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 59610 | MA |
Y | 2080P0204X | Pediatric Emergency Doctor | 59610 | MA |
NPI | 1013954916 |
---|---|
Provider Name | Dr. Sara A Schutzman |
First Address | Boston, MA 02115-5724 |
Second Address | Boston, MA 02115-5724 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/05/2006 |
Last Update Date | 20/08/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3044408 | (05) | MA |
E07427 | (02) |