Individual
ALEXANDRA IVANOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
55 FOGG RD, SOUTH WEYMOUTH, MA 02190-2432
(781) 624-8000
Mailing address
12 HANCOCK ST APT 1, SOMERVILLE, MA 02144-3103
(727) 385-5715
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
0
MA
Other
Enumeration date
06/12/2025
Last updated
06/12/2025
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