Healthcare Provider Details

I. General information

NPI: 1003773193
Provider Name (Legal Business Name): BARBARA IBANDA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/08/2026
Last Update Date: 01/08/2026
Certification Date: 01/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 1ST AVE
NEEDHAM HEIGHTS MA
02494-2736
US

IV. Provider business mailing address

15 CASTLEWOOD DR
BILLERICA MA
01821-3203
US

V. Phone/Fax

Practice location:
  • Phone: 617-542-9991
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License NumberRN2332839
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: