Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | 203312 | MA |
N | 207VE0102X | Reproductive Endocrinologist | MD9920 | RI |
NPI | 1235162512 |
---|---|
Provider Name | Kelly Pagidas |
First Address | Boston, MA 02241-5348 |
Second Address | Worcester, MA 01605 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/07/2006 |
Last Update Date | 17/08/2018 |