Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0400X | Neurologist | 247562 | MA |
NPI | 1013115922 |
---|---|
Provider Name | Rebecca Burch |
First Address | Jamaica Plain, MA 02130-3446 |
Second Address | Jamaica Plain, MA 02130-3446 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/07/2007 |
Last Update Date | 20/11/2017 |