Individual
IRINA ILIEVA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
55 FRUIT ST, BOSTON, MA 02114-2621
(857) 238-5900
Mailing address
55 FRUIT ST, BOSTON, MA 02114-2621
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN2261191
MA
Other
Enumeration date
09/11/2015
Last updated
09/11/2015
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