Individual
VITION MBRICA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
80 SUMMER ST # 1, BOSTON, MA 02110-1218
(617) 865-2749
Mailing address
11A MOUNT VERNON ST APT 3, DORCHESTER, MA 02125-1793
(857) 399-5899
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
06/12/2023
Last updated
04/09/2024
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