Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 209793 | MA |
Y | 2080P0214X | Pediatric Pulmonologist | 209793 | MA |
NPI | 1407846678 |
---|---|
Provider Name | Eliot S Katz |
First Address | Boston, MA 02115 |
Second Address | Boston, MA 02115 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/10/2005 |
Last Update Date | 04/12/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0141470 | (05) | MA |
209793 | TUFTS HEALTH PLAN (01) | MA |
F11601 | (02) | |
J23495 | BCBS MA (01) | MA |