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General NPI Number Information
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NPI Number | 1861029969
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Entity Type | Individual
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Provider Name | EMMA HYDE
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Gender | Female
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Dates
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Enumeration Date | 03/26/2020
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Last Update Date | 11/04/2024
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Provider Practice Location Address
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Address Line | 300 CONGRESS ST STE 102
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City | QUINCY
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State | MA
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Zip | 02169-0907
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Country | US
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Telephone | 617-479-6636
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Fax | 617-472-9868
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Provider Business Mailing Address
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Address Line | 1 MEDICAL DR DEPT OF
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City | LEBANON
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State | NH
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Zip | 03756-1000
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Country | US
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Telephone |
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Fax |
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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 | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 1019370
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License Number State | MA
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