Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PE0004X | Emergency Medical Services | 43003 | MA |
NPI | 1114031705 |
---|---|
Provider Name | Stephen J Playe |
First Address | Springfield, MA 01199-1000 |
Second Address | Palm Coast, FL 32137-3808 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/08/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
B74069 | (02) | MA |