Individual
TY THI IANCOVICI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
10 GOVE ST, EAST BOSTON, MA 02128-1920
(617) 569-5800
Mailing address
10 GOVE ST, EAST BOSTON, MA 02128-1920
(617) 569-5800
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN2262113
MA
Other
Enumeration date
01/28/2016
Last updated
03/26/2019
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