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Vivian Ibanez
NPI 1174907588 · on the registry since 2015
Practice
- Address
- 130 Condor Street
East Boston, MA 02128 - Phone
- (617) 569-6560
- Organisation at this address
- North Suffolk Community Services Inc.
Inferred from a shared address, not stated in the registry.
- Clinicians at this address
- 48
Registry record
- Primary taxonomy
- Specialist
174400000X
- Licence states on file
- MA
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2015-07-15
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Massachusetts