Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | MT215483 | PA |
NPI | 1003300500 |
---|---|
Provider Name | Lorenzo Albala |
First Address | Boston, MA 02114-2696 |
Second Address | Boston, MA 02114-2696 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/06/2018 |
Last Update Date | 27/06/2019 |