Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0505X | Family Doctor - Adult Medicine | 151026 | MA |
NPI | 1255307211 |
---|---|
Provider Name | Eleni Rethimiotakis |
First Address | Dartmouth, MA 02747-1242 |
Second Address | Dartmouth, MA 02747-1242 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/02/2006 |
Last Update Date | 07/02/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3163504 | (05) | MA |
71286 | HARVARD-PILGRIM HEALTHCARE (01) | MA |
G43438 | (02) | |
J17452 | BCBS-MA (01) | MA |