Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 250732 | MA |
N | 111NI0900X | Internist | 250732 | MA |
Y | 207RH0000X | Hematologist | 250732 | MA |
N | 207RX0202X | Medical Oncology | 250732 | MA |
NPI | 1083840607 |
---|---|
Provider Name | Shayna R. Sarosiek |
First Address | Boston, MA 02118 |
Second Address | Boston, MA 02118-2905 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/06/2009 |
Last Update Date | 27/09/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
11092463A | (05) | MA |