Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0003X | Hematology & Oncology | 152492 | MA |
NPI | 1013995992 |
---|---|
Provider Name | Dr. Irina Gurevich |
First Address | Plymouth, MA 02360-2183 |
Second Address | Plymouth, MA 02360-2183 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/01/2006 |
Last Update Date | 28/11/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0170836 | (05) | MA |
14771 | HARVARD PILGRIM (01) | MA |
152492 | TUFTS HEALTH PLAN (01) | MA |
H60990 | (02) | MA |
J24893 | BCBSMA (01) | MA |