Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PP0204X | Pediatric Emergency Physician | 208732 | MA |
NPI | 1083658686 |
---|---|
Provider Name | Paul Kotzampaltiris |
First Address | Natick, MA 01760-0005 |
Second Address | Framingham, MA 01702 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/06/2006 |
Last Update Date | 08/03/2011 |