Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 224232 | MA |
N | 2080P0205X | Pediatric Endocrinologist | 224232 | MA |
NPI | 1114138765 |
---|---|
Provider Name | Elizabeth Tan Rosolowsky |
First Address | Watertown, MA 02472-1968 |
Second Address | Boston, MA 02115-5711 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/05/2007 |
Last Update Date | 08/07/2007 |