Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LW0102X | Nurse Practitioner - Women's Health | 261656 | MA |
NPI | 1043359771 |
---|---|
Provider Name | Bianca Passarelli |
First Address | Boston, MA 02118-2371 |
Second Address | Boston, MA 02118-4001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/02/2007 |
Last Update Date | 10/07/2017 |