Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | 11202 | NH |
Y | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | 156127 | MA |
NPI | 1194776658 |
---|---|
Provider Name | Rosemary Ellen Reiss |
First Address | Boston, MA 02115 |
Second Address | Boston, MA 02115 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/05/2006 |
Last Update Date | 11/10/2019 |