Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XL0004X | Low Vision | 1027 | MA |
NPI | 1871865063 |
---|---|
Provider Name | Sharon A Engelhardt |
First Address | Newton, MA 02465-1637 |
Second Address | Boston, MA 02109-2106 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/02/2012 |
Last Update Date | 02/02/2012 |