Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | 270972 | MA |
Y | 111NI0900X | Internist | 270972 | MA |
N | 207RG0300X | Geriatric Medicine | 266983 | MA |
NPI | 1023458411 |
---|---|
Provider Name | Dr. Ariadne Stephanie Scott Iriarte |
First Address | Boston, MA 02118-5152 |
Second Address | Beverly, MA 01915 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/06/2013 |
Last Update Date | 04/02/2021 |