Vivian Karina Ibanez

NPI #1174907588 in East Boston, Massachusetts

Provider Information

NPI Number: 1174907588
Entity Type: Individual
Name: Vivian Karina Ibanez
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Specialist
Enumeration Date: Jul 15, 2015
Last Updated: Jul 15, 2015

Practice Location

Address: 130 CONDOR STREET
City: East Boston
State: Massachusetts
ZIP Code: 02128
Phone: (617) 569-6560

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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