Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 77454 | MA |
N | 2080P0204X | Pediatric Emergency Doctor | 037192 | CT |
Y | 2080P0204X | Pediatric Emergency Doctor | 77454 | MA |
NPI | 1063487569 |
---|---|
Provider Name | Holly E Perry |
First Address | Springfield, MA 01199 |
Second Address | Springfield, MA 01199-1001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/02/2006 |
Last Update Date | 22/07/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
001371921 | (05) | CT |
F49114 | (02) | CT |