Healthcare Provider Details

I. General information

NPI: 1477230126
Provider Name (Legal Business Name): RIRY IPTARIA NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/03/2023
Last Update Date: 03/12/2024
Certification Date: 03/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

140 WOOD RD STE 305
BRAINTREE MA
02184-2514
US

IV. Provider business mailing address

377 WILLARD ST STE 342
QUINCY MA
02169-6122
US

V. Phone/Fax

Practice location:
  • Phone: 857-246-9393
  • Fax: 980-500-2086
Mailing address:
  • Phone: 857-246-9393
  • Fax: 980-500-2086

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberRN2309815
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: