Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213E00000X | Podiatrist | 1982 | MA |
N | 222Z00000X | Podiatrist | 1982 | MA |
Y | 213ES0131X | Foot Surgery | 1982 | MA |
NPI | 1255411070 |
---|---|
Provider Name | Dr. Irina B. Vasserman |
First Address | Canton, MA 02021-2096 |
Second Address | Canton, MA 02021-2096 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/10/2006 |
Last Update Date | 31/12/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0357863 | (05) | MA |
2700320 | UNITED HEALTH CARE (01) | MA |
333065 | HPHC (01) | MA |
4523040001 | DME (01) | MA |
480033203 | RRM (01) | MA |
728979 | TUFTS (01) | MA |
980614 | AETNA (01) | MA |
B20429901 | CIGNA (01) | MA |
U35033 | (02) | MA |
Y70960 | BCBS (01) | MA |