Individual
EVGENIYA LARIONOVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
330 BROOKLINE AVENUE, BOSTON, MA 02149-2507
(617) 667-2845
Mailing address
330 BROOKLINE AVENUE, BOSTON, MA 02215
(617) 667-2845
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
RN2312890
MA
363LF0000X
Family Nurse Practitioner
RN2312890
MA
Other
Enumeration date
06/29/2018
Last updated
12/27/2018
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