Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XL0004X | Low Vision | 003905 | CT |
NPI | 1043576879 |
---|---|
Provider Name | Kimberly Ann Zaniewski |
First Address | Boston, MA 02109-2106 |
Second Address | Boston, MA 02109-2106 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/04/2012 |
Last Update Date | 05/04/2012 |