Individual
HILDRED B PENNOYER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
133 BROOKLINE AVE, INTERNAL MEDICINE, BOSTON, MA 02215-3904
(617) 421-5804
(617) 421-8865
Mailing address
147 MILK ST, PROVIDER ENROLLMENT - 9TH FLOOR, BOSTON, MA 02109-4806
(617) 559-8374
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
70598
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0015265
NEIGHBORHOOD HEATLH
MA
05
—
3190650
—
MA
01
—
467259
TUFTS
MA
01
—
J13617
BLUE CROSS
MA
01
—
PV290
HARVARD PILGRIM
MA
Enumeration date
06/22/2006
Last updated
06/08/2011
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