Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | 154221 | MA |
NPI | 1033177050 |
---|---|
Provider Name | Victoria R Cavalli |
First Address | North Adams, MA 01247-3460 |
Second Address | North Adams, MA 01247-3416 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/05/2006 |
Last Update Date | 07/07/2011 |