Individual
REGINA IBENEME
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
415 COLUMBIA RD, DORCHESTER, MA 02125-2424
(617) 740-8083
Mailing address
415 COLUMBIA RD, DORCHESTER, MA 02125-2424
(617) 740-8083
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
254260
MA
Other
Enumeration date
05/19/2008
Last updated
05/19/2008
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