Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PP0204X | Pediatric Emergency Physician | 232251 | MA |
NPI | 1073588075 |
---|---|
Provider Name | Kenneth P Platt |
First Address | Springfield, MA 01199 |
Second Address | Springfield, MA 01199 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/02/2006 |
Last Update Date | 13/05/2011 |