Individual
DR. JOHANNA C ITURRINO MOREDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
330 BROOKLINE AVE, BOSTON, MA 02215-5400
(617) 667-2137
Mailing address
330 BROOKLINE AVE, BOSTON, MA 02215-5400
(617) 667-2137
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
17220
PR
207RG0100X
Gastroenterology Physician
266575
MA
207RG0100X
Gastroenterology Physician
Primary
52247
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ENROLLED
—
IA
05
—
ENROLLED
—
MN
05
—
ENROLLED
—
WI
01
—
P01195948
RAILROAD MEDICARE
MN
Enumeration date
08/20/2007
Last updated
08/29/2016
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