Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0122X | Plastic and Reconstructive Surgery | 242538 | MA |
NPI | 1144480401 |
---|---|
Provider Name | Joyce K. Mcintyre |
First Address | Boston, MA 02241-5348 |
Second Address | Worcester, MA 01605-2138 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/06/2008 |
Last Update Date | 05/11/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
110102795A | (05) | MA |