Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | 289672 | MA |
NPI | 1083290084 |
---|---|
Provider Name | William Pellegrini |
First Address | Boston, MA 02118-2905 |
Second Address | Boston, MA 02118-2905 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/03/2021 |
Last Update Date | 09/07/2021 |