Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204F00000X | Transplant Surgeon | 266179 | NY |
Y | 204F00000X | Transplant Surgeon | 272482 | MA |
NPI | 1457592305 |
---|---|
Provider Name | Dr. Vanessa Lyn Cowan |
First Address | Boston, MA 02215 |
Second Address | Boston, MA 02215 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/03/2009 |
Last Update Date | 17/03/2018 |