Individual
JAIMIE MANLUCU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
33 POND AVE, UNIT 1013, BROOKLINE, MA 02445-7163
(617) 732-5500
Mailing address
75 FRANCIS ST, BOSTON, MA 02115-6110
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
247521
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
247521
IN TRAINING
MA
Enumeration date
07/21/2011
Last updated
07/21/2011
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