Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0205X | Pediatric Endocrinologist | 262994 | MA |
NPI | 1497015440 |
---|---|
Provider Name | Jessica Kremen |
First Address | Boston, MA 02115-5711 |
Second Address | Boston, MA 02115-5711 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/05/2012 |
Last Update Date | 29/06/2015 |