Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 242905 | MA |
Y | 2080P0202X | Pediatric Cardiologist | 242905 | MA |
NPI | 1043257546 |
---|---|
Provider Name | Mark V. Zilberman |
First Address | Boston, MA 02111-1552 |
Second Address | Boston, MA 02111-1552 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/06/2006 |
Last Update Date | 11/04/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
481452710 | (05) | MI |
700H262280 | BLUE CROSS-BLUE CROSS (01) | |
I22045 | (02) | |
MZ082041 | CHAMPUS-CHAMPUS (01) | |
MZ082041 | COMMERCIAL-COMMERCIAL NUMBER (01) |