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General NPI Number Information
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NPI Number | 1174579718
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Entity Type | Individual
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Provider Name | GIANNOULA LAKKA KLEMENT MD
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Gender | Female
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Dates
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Enumeration Date | 05/25/2006
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Last Update Date | 09/01/2009
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Provider Practice Location Address
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Address Line | 800 WASHINGTON ST FLOATING HOSPITAL FOR CHILDREN AT TUFTS MEDICAL CENTER
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City | BOSTON
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State | MA
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Zip | 02111-1552
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Country | US
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Telephone | 617-636-5535
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Fax | 617-636-7738
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Provider Business Mailing Address
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Address Line | 45 HEMENWAY ST UNIT 1
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City | BOSTON
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State | MA
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Zip | 02115
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Country | US
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Telephone | 617-536-0515
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Fax | 617-562-7142
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2080P0207X
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Taxonomy Name | Pediatric Hematology & Oncology Physician
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License Number | 219313
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License Number State | MA
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