Individual
MARY DOLORES DOHERTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PEDIATRIC NURSE PRAC
Contact information
Practice address
243 CHARLES STREET, ANESTHESIA DEPARTMENT, BOSTON, MA 02114
(617) 573-3380
(617) 573-4033
Mailing address
243 CHARLES STREET, MASSACHUSETTS EYE & EAR INFIRMARY, BOSTON, MA 02114
(617) 573-3380
(617) 573-4033
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
RN133659
MA
Other
Enumeration date
09/20/2010
Last updated
09/20/2010
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