Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RE0101X | Endocrinologist (Diabetes Doctor) | 268577 | MA |
NPI | 1073753414 |
---|---|
Provider Name | Dr. Ivania Rizo |
First Address | Boston, MA 02118 |
Second Address | Boston, MA 02118 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/02/2009 |
Last Update Date | 19/01/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
110119425A | (05) | MA |
P00908556 | RAILROAD MEDICARE ID-RSFPN (01) | SC |