Individual provider · Type 1 NPI
Vivian Karina Ibanez
Specialist · East Boston, MA
NPI number
1174907588
Active
Practice location
130 Condor Street
East Boston, MA 02128
Mailing address
31 Ware St.
Dedham, MA 02026
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Specialist Primary | 174400000X | 042317215 (MA) |
Specialist: An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
Other specialist providers in East Boston
About NPI 1174907588
Vivian Karina Ibanez's National Provider Identifier is 1174907588, issued on Jul 15, 2015. The primary taxonomy on file is Specialist (174400000X), and the practice location is in East Boston, MA. The record was last updated on Jul 15, 2015.