Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0200X | Nurse Practitioner - Pediatrics | RN2264201 | MA |
NPI | 1023649753 |
---|---|
Provider Name | Leah Hirshberg |
First Address | Leverett, MA 01054-9725 |
Second Address | Leverett, MA 01054-9725 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/01/2020 |
Last Update Date | 31/01/2020 |