Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP2300X | Nurse Practitioner - Primary Care | 135750NP | MA |
NPI | 1053348110 |
---|---|
Provider Name | Mrs. Sheila O Poswolsky |
First Address | Cambridge, MA 02139-2249 |
Second Address | Boston, MA 02130-4817 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/06/2006 |
Last Update Date | 08/07/2007 |