Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0210X | Pediatric Nephrologist | 208975 | MA |
NPI | 1407847056 |
---|---|
Provider Name | Elahna Paul |
First Address | Charlestown, MA 02129-9142 |
Second Address | Boston, MA 02114-2621 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/11/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0125130 | (05) | MA |
208975 | TUFTS HEALTH PLAN (01) | MA |
H33909 | (02) | |
J23368 | BCBS MA (01) | MA |