Individual
DR. STANLEY IP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
750 WASHINGTON ST, NEMC #63, BOSTON, MA 02111-1526
(617) 636-5241
Mailing address
750 WASHINGTON ST, NEMC #63, BOSTON, MA 02111-1526
(617) 636-5241
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
55519
MA
208000000X
Pediatrics Physician
G47881
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3082440
—
MA
Enumeration date
04/10/2007
Last updated
07/08/2007
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