Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0207X | Pediatric Hematology-Oncologist | 56413 | MA |
NPI | 1174599930 |
---|---|
Provider Name | Mr. Alan David Dandrea |
First Address | Winchester, MA 01890-3535 |
Second Address | Boston, MA 02115-6084 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/02/2006 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
056413 | TUFTS (01) | |
23285 | FALLON HEALTH PLAN (01) | |
2927580 | AETNA US HEALTHCARE (01) | |
3063518 | (05) | MA |
4147276 | CIGNA (01) | |
7504070 | UNITED HEALTH CARE (01) | |
A59704 | (02) | |
A59704DF | HPHC (01) |