Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0000X | Obstetrician | 278225 | MA |
NPI | 1356737456 |
---|---|
Provider Name | Jean Chavez Hostage |
First Address | Boston, MA 02111-1552 |
Second Address | Boston, MA 02111 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/04/2015 |
Last Update Date | 20/05/2019 |