Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RE0101X | Endocrinologist (Diabetes Doctor) | 51819 | MA |
NPI | 1043257512 |
---|---|
Provider Name | Pamela I Hartzband |
First Address | Boston, MA 02215-5400 |
Second Address | Boston, MA 02215-5400 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/06/2006 |
Last Update Date | 04/02/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
6175414 | (05) | MA |
D82868 | (02) | MA |
J02936 | BCBS (01) | MA |