Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0120X | Pediatric Surgery | 30607 | MA |
NPI | 1194868653 |
---|---|
Provider Name | Richard A Courtney |
First Address | Springfield, MA 01103-1114 |
Second Address | Springfield, MA 01103-1114 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/02/2007 |
Last Update Date | 08/07/2007 |