Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111NR0200X | Radiology | 21008 | NY |
N | 213ER0200X | Radiology | 21008 | NY |
NPI | 1437570645 |
---|---|
Provider Name | Theresa V Mills |
First Address | South Dennis, MA 02660-3739 |
Second Address | Northborough, MA 01532-1662 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/12/2013 |
Last Update Date | 16/12/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
21008 | ARDMS (01) | MA |