Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RE0101X | Endocrinologist (Diabetes Doctor) | 230618 | MA |
N | 207RE0101X | Endocrinologist (Diabetes Doctor) | MD08376 | RI |
NPI | 1063459386 |
---|---|
Provider Name | James V Hennessey |
First Address | Boston, MA 02215-1358 |
Second Address | Boston, MA 02215-4141 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/06/2006 |
Last Update Date | 17/02/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
9006723 | (05) | RI |
A17566 | (02) |