Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | 273244 | MA |
N | 208000000X | Pediatrician | 273244 | MA |
NPI | 1053758201 |
---|---|
Provider Name | Katherine L Tuttle |
First Address | Boston, MA 02118 |
Second Address | Boston, MA 02115-6110 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/05/2013 |
Last Update Date | 27/08/2019 |