Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0207X | Pediatric Hematology-Oncologist | 219313 | MA |
NPI | 1174579718 |
---|---|
Provider Name | Giannoula Lakka Klement |
First Address | Boston, MA 02115 |
Second Address | Boston, MA 02111-1552 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/05/2006 |
Last Update Date | 01/09/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2025990 | MASSHEALTH (MA MEDICAID) (01) | |
219313 | TUFTS (01) | |
4460262 | CIGNA (01) | |
80300 | FALLON COMMUNITY HEALTH P (01) | |
AA11828 | HPHC (DFCI ONLY) (01) | |
H99720 | (02) | |
J26938 | BCBS OF MA, INDEMNITY, BC (01) |