Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207KA0200X | Allergist | 28368 | MA |
NPI | 1477648582 |
---|---|
Provider Name | John M. O'loughlin |
First Address | Leominster, MA 01453 |
Second Address | Leominster, MA 01453 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/10/2006 |
Last Update Date | 13/06/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
6167373 | (05) | MA |
A65902 | (02) | MA |