Healthcare Provider Details

I. General information

NPI: 1134319262
Provider Name (Legal Business Name): LUCIA E CIUREA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/25/2007
Last Update Date: 07/25/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

274 CLARENDON ST APT #2
BOSTON MA
02116-1305
US

IV. Provider business mailing address

274 CLARENDON ST APT #2
BOSTON MA
02116-1305
US

V. Phone/Fax

Practice location:
  • Phone: 617-536-6864
  • Fax:
Mailing address:
  • Phone: 617-536-6864
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number43772
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: