Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | 267810 | MA |
NPI | 1043583834 |
---|---|
Provider Name | Petya T. Papazova |
First Address | Boston, MA 02120-2847 |
Second Address | Boston, MA 02120-2847 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/02/2012 |
Last Update Date | 09/02/2012 |