Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RA0401X | Internist - Addiction Medicine | 289004 | MA |
NPI | 1588105985 |
---|---|
Provider Name | Patricia De Lima |
First Address | Taunton, MA 02780 |
Second Address | Bronx, NY 10467-2401 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/03/2017 |
Last Update Date | 13/12/2021 |