Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | RN270572 | MA |
NPI | 1023517380 |
---|---|
Provider Name | Dr. Tina Luisa Alibozek |
First Address | Adams, MA 01220-9720 |
Second Address | Pittsfield, MA 01201-4109 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/02/2018 |
Last Update Date | 01/02/2018 |