Individual
IRINA SELIVERSTOV
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
34 STATE ST, LYNN, MA 01901-1505
(781) 581-6181
(781) 599-3229
Mailing address
34 STATE ST, LYNN, MA 01901-1505
(781) 581-6181
(781) 599-3229
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
218125
MD
Other
Enumeration date
08/12/2005
Last updated
07/08/2007
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