Provider Demographics
NPI:1780623116
Name:HAPPE, HOLLY E (DO)
Entity type:Individual
Prefix:DR
First Name:HOLLY
Middle Name:E
Last Name:HAPPE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:160 BOYLSTON ST
Mailing Address - Street 2:APT 2154
Mailing Address - City:CHESTNUT HILL
Mailing Address - State:MA
Mailing Address - Zip Code:02467-2007
Mailing Address - Country:US
Mailing Address - Phone:202-550-7078
Mailing Address - Fax:
Practice Address - Street 1:243 CHARLES ST
Practice Address - Street 2:ROOM 713
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-3002
Practice Address - Country:US
Practice Address - Phone:617-573-3380
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-04
Last Update Date:2011-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD408577900Medicaid
DCP00616344OtherRAILROAD MEDICARE
MD408577900Medicaid
DC003267M65Medicare PIN
DCP00616344OtherRAILROAD MEDICARE