Individual
GLORIA ALFARO-NIEVES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
142 CRESCENT ST, BROCKTON, MA 02302-3104
(508) 232-6670
Mailing address
142 CRESCENT ST, BROCKTON, MA 02302-3104
(508) 232-6670
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1303295
—
MA
05
—
1307576
—
MA
01
—
M18463
BLUE CROSS BLUE SHIELD
MA
Enumeration date
04/09/2015
Last updated
04/09/2015
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