Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | 23484 | MA |
NPI | 1215970660 |
---|---|
Provider Name | Irving W. Bailit |
First Address | Boston, MA 02109-4806 |
Second Address | Wellesley, MA 02481-5420 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/06/2006 |
Last Update Date | 07/04/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0014421 | NEIGHBORHOOD HEALTH PLAN (01) | MA |
0103713 | (05) | MA |
023484 | TUFTS HEALTH PLAN (01) | MA |
9180367-002 | CIGNA (01) | MA |
A41233 | (02) | MA |
C16023 | BLUE CROSS (01) | MA |
PA117 | HARVARD PILGRIM (01) | MA |