Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081S0010X | Sports Medicine | 3496 | MA |
Y | 213ES0000X | Sports Medicine | 3496 | MA |
NPI | 1134735392 |
---|---|
Provider Name | Meredith Celine Harrington |
First Address | Brockton, MA 02301-5674 |
Second Address | Brockton, MA 02301-5674 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/09/2020 |
Last Update Date | 22/09/2020 |