Individual
BIANA KORJEVSKY MICO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
195 WORCESTER ST, SUITE 102, WELLESLEY, MA 02481-5568
(617) 219-1510
Mailing address
62 BRUCEWOOD ST, WEST ROXBURY, MA 02132-1304
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN2278675
MA
Other
Enumeration date
08/05/2015
Last updated
07/09/2016
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