Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0214X | Pediatric Pulmonologist | 253465 | MA |
NPI | 1184851909 |
---|---|
Provider Name | Michelle K Trivedi |
First Address | Boston, MA 02241-5348 |
Second Address | Worcester, MA 01655-0002 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/06/2009 |
Last Update Date | 09/11/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
110094833A | (05) | MA |