Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081S0010X | Sports Medicine | 2281 | MA |
Y | 213ES0000X | Sports Medicine | 2281 | MA |
NPI | 1235722729 |
---|---|
Provider Name | Kathryn Annunziata |
First Address | Boston, MA 02116-4608 |
Second Address | Boston, MA 02116-4608 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/02/2021 |
Last Update Date | 16/02/2021 |