Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0105X | Surgery of the Hand | 281430 | MA |
NPI | 1386806867 |
---|---|
Provider Name | Nicholas M Elisseou |
First Address | Boston, MA 02135-2907 |
Second Address | Boston, MA 02135-2907 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/06/2008 |
Last Update Date | 26/02/2020 |