Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 224760 | MA |
N | 111NI0900X | Internist | 224760 | MA |
Y | 207R00000X | Internist | 235223 | MA |
Y | 111NI0900X | Internist | 235223 | MA |
NPI | 1003090143 |
---|---|
Provider Name | Joseph Dubin |
First Address | Boston, MA 02241-5348 |
Second Address | Burlington, MA 01805-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/12/2007 |
Last Update Date | 22/03/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
110079785A | (05) | MA |