Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 56849 | MA |
N | 207XS0106X | Orthopaedic Hand Surgeon | 56849 | MA |
NPI | 1205810017 |
---|---|
Provider Name | Dr. Thomas F Breen |
First Address | Boston, MA 02241-0001 |
Second Address | Worcester, MA 01605-2138 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/12/2005 |
Last Update Date | 27/10/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
110043810A | (05) | MA |
B95319 | (02) | MA |