Individual
DR. MARIA TERESA VIVALDI
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
55 FRUIT STREET, VBK 508, BOSTON, MA 02114-2696
(617) 726-8871
Mailing address
PO BOX 9142, CHARLESTOWN, MA 02129-9142
(617) 724-0287
(617) 726-2894
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
77673
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
077673
TUFTS HEALTH PLAN
MA
05
—
3147436
—
MA
01
—
J31438
BCBS
MA
Enumeration date
01/10/2006
Last updated
07/08/2007
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