Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | 159349 | MA |
Y | 207QA0401X | Family Doctor - Addiction Medicine | 159349 | MA |
N | 207QA0401X | Family Doctor - Addiction Medicine | 16460 | NH |
N | 207QA0401X | Family Doctor - Addiction Medicine | 52615 | CT |
N | 207QA0401X | Family Doctor - Addiction Medicine | MD19870 | ME |
NPI | 1659356574 |
---|---|
Provider Name | Heidi Ginter |
First Address | Westfield, MA 01085-3464 |
Second Address | Westfield, MA 01085-3464 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/12/2005 |
Last Update Date | 16/05/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1301071 | (05) | MA |
1306421 | (05) | MA |
1308785 | (05) | MA |
G93124 | (02) | MA |