Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RR0500X | Rheumatology | 30782 | MA |
NPI | 1063483931 |
---|---|
Provider Name | Harry Dinerman |
First Address | Birghton, MA 02135 |
Second Address | Brighton, MA 02135 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/01/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
6189229 | (05) | MA |
A56694 | (02) |