Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | 54691 | MA |
N | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | 54691 | MA |
NPI | 1144203548 |
---|---|
Provider Name | Linda J Heffner |
First Address | Boston, MA 02118-2371 |
Second Address | Boston, MA 02118-4001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/11/2005 |
Last Update Date | 07/08/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
110065988A | (05) | MA |