Individual
VANRIA V IYAMU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2100 DORCHESTER AVE, DORCHESTER CENTER, MA 02124-5615
(617) 506-4471
Mailing address
35 MEADOWVIEW RD, MILTON, MA 02186-1322
(617) 506-4471
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
AP1776
MA
Other
Enumeration date
04/04/2007
Last updated
07/08/2007
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