Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | 0142632 | CT |
N | 208000000X | Pediatrician | 245974 | MA |
NPI | 1003962739 |
---|---|
Provider Name | Mrs. Elena Doina Dragoi |
First Address | West Bridgewater, MA 02379 |
Second Address | West Bridgewater, MA 02379 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/01/2007 |
Last Update Date | 21/11/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00426320 | (05) | CT |