Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251C2600X | Cardiopulmonary | 15102 | MA |
NPI | 1063644664 |
---|---|
Provider Name | Lauren J Healey |
First Address | Braintree, MA 02184-6858 |
Second Address | Newton, MA 02462-1607 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/08/2009 |
Last Update Date | 14/08/2009 |