Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207KA0200X | Allergist | 72804 | MA |
N | 207R00000X | Internist | 72804 | MA |
N | 111NI0900X | Internist | 72804 | MA |
N | 207RA0201X | Internist - Allergy & Immunology | 72804 | MA |
N | 207RC0200X | Critical Care Medicine | 72804 | MA |
Y | 207RP1001X | Pulmonary Disease | 72804 | MA |
NPI | 1568433878 |
---|---|
Provider Name | Jussi J. Saukkonen |
First Address | Boston, MA 02118-4001 |
Second Address | Boston, MA 02118-2526 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/01/2006 |
Last Update Date | 10/07/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3092691 | (05) | MA |
F26774 | (02) | MA |