Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207ND0900X | Dermatopathologist | 001708 | NY |
NPI | 1043206527 |
---|---|
Provider Name | Elsa Velazquez-Mcguirk |
First Address | Walpole, MA 02081-5010 |
Second Address | Needham, MA 02494-2618 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/09/2005 |
Last Update Date | 01/06/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H77337 | (02) | NY |