Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | 199044 | MA |
N | 363LP0200X | Nurse Practitioner - Pediatrics | RN199044 | MA |
NPI | 1033310156 |
---|---|
Provider Name | Ms. Molly B Meyersohn |
First Address | Boston, MA 02115-5724 |
Second Address | Boston, MA 02115-5724 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/05/2007 |
Last Update Date | 30/11/2019 |