Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0205X | Pediatric Endocrinologist | 280123 | MA |
NPI | 1467795450 |
---|---|
Provider Name | Tara Kaushal |
First Address | Boston, MA 02215-5306 |
Second Address | Boston, MA 02215 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/03/2013 |
Last Update Date | 06/09/2019 |