Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 273921 | MA |
Y | 2080P0214X | Pediatric Pulmonologist | 273921 | MA |
NPI | 1124450952 |
---|---|
Provider Name | Levent Midyat |
First Address | Boston, MA 02115-5711 |
Second Address | Boston, MA 02115-5711 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/08/2013 |
Last Update Date | 23/05/2019 |