Healthcare Provider Details

I. General information

NPI: 1922340702
Provider Name (Legal Business Name): LAUREN J. CIPRIANI-ESPINEIRA PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LAUREN CIPRIANI

II. Dates (important events)

Enumeration Date: 03/20/2013
Last Update Date: 03/26/2024
Certification Date: 03/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

725 ALBANY ST STE 4B
BOSTON MA
02118
US

IV. Provider business mailing address

960 MASSACHUSETTS AVE FL 2
BOSTON MA
02118-2690
US

V. Phone/Fax

Practice location:
  • Phone: 617-638-5633
  • Fax: 617-414-5226
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA4665
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: