Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | 284947 | MA |
Y | 111NI0900X | Internist | 284947 | MA |
N | 207R00000X | Internist | ETLL-746 | MA |
N | 111NI0900X | Internist | ETLL-746 | MA |
NPI | 1003432535 |
---|---|
Provider Name | Erica Mary Haas |
First Address | Brighton, MA 02135-2907 |
Second Address | Brighton, MA 02135-2907 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/06/2020 |
Last Update Date | 06/07/2020 |