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1871571539 NPI number — K. GARY VANASSE MD

NPI Number: 1871571539
Health Care Provider/Practitioner: K. GARY VANASSE MD

Information about “1871571539” NPI (K. GARY VANASSE MD) exists in 1871571539 in HTML format HTML  |  1871571539 in plain Text format TXT  |  1871571539 in PDF (Portable Document Format) PDF  |  1871571539 in an XML format XML  formats.

NPI Number : 1871571539 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1871571539",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "VANASSE",
    "FirstName": "K.",
    "MiddleName": "GARY",
    "NamePrefix": "DR.",
    "NameSuffix": null,
    "Credential": "MD",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "VANASSE",
    "OtherFirstName": "KIM",
    "OtherMiddleName": "JOSEPH",
    "OtherNamePrefix": "DR.",
    "OtherNameSuffix": null,
    "OtherCredential": "MD",
    "OtherLastNameTypeCode": "2",
    "FirstLineMailingAddress": "75 FRANCIS ST",
    "SecondLineMailingAddress": "KARP 5.216",
    "MailingAddressCityName": "BOSTON",
    "MailingAddressStateName": "MA",
    "MailingAddressPostalCode": "02115-6110",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "617-732-5840",
    "MailingAddressFaxNumber": "617-732-5706",
    "FirstLinePracticeLocationAddress": "75 FRANCIS ST",
    "SecondLinePracticeLocationAddress": "KARP 5.216",
    "PracticeLocationAddressCityName": "BOSTON",
    "PracticeLocationAddressStateName": "MA",
    "PracticeLocationAddressPostalCode": "02115-6110",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "617-732-5840",
    "PracticeLocationAddressFaxNumber": "617-732-5706",
    "EnumerationDate": "01/04/2006",
    "LastUpdateDate": "03/13/2008",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "207RH0003X",
        "TaxonomyName": "Hematology & Oncology Physician",
        "LicenseNumber": "PENDING",
        "LicenseNumberStateCode": "MA",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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