Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0905X | Otolaryngology/Facial Plastic Surgery | 276414 | MA |
NPI | 1316280886 |
---|---|
Provider Name | Louis F Insalaco |
First Address | Stoneham, MA 02180-2445 |
Second Address | Stoneham, MA 02180-2445 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/04/2013 |
Last Update Date | 23/07/2019 |