Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 208809 | MA |
N | 111NI0900X | Internist | 208809 | MA |
Y | 207RR0500X | Rheumatology | 208809 | MA |
NPI | 1114024379 |
---|---|
Provider Name | Susan C Kovacs |
First Address | Burlington, MA 01805-0001 |
Second Address | Burlington, MA 01805-0001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/09/2006 |
Last Update Date | 16/11/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0144657 | (05) | MA |
110003705A | (05) | MA |
G07292 | (02) | MA |