Individual
LARISA VLADIMIROVNA BUKHOVKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
20 LINDEN ST, ALLSTON, MA 02134-1711
(617) 782-9900
Mailing address
3 BROADMOOR LN, PEABODY, MA 01960-4951
(978) 818-5705
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
AG10210012
MA
363L00000X
Nurse Practitioner
Primary
RN2290340
MA
Other
Enumeration date
10/18/2021
Last updated
10/18/2021
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