Individual
GRACE ELAINE RIVERA OWEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
55 FRUIT ST, BOSTON, MA 02114-2696
(617) 643-0707
Mailing address
6 SUNDANCE LN, BOW, NH 03304-4908
(603) 724-1456
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
1023652
MA
Other
Enumeration date
05/09/2022
Last updated
06/06/2025
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