Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | 272829 | MA |
NPI | 1003221995 |
---|---|
Provider Name | Neety Patel |
First Address | Boston, MA 02241-5348 |
Second Address | Fitchburg, MA 01420-5140 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/06/2014 |
Last Update Date | 23/10/2020 |