Healthcare Provider Details

I. General information

NPI: 1518120997
Provider Name (Legal Business Name): MELVIN A. AREIZAGA RN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/07/2008
Last Update Date: 07/07/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

89 BATEMAN ST
ROSLINDALE MA
02131-4902
US

IV. Provider business mailing address

1400 VFW PKWY
WEST ROXBURY MA
02132-4927
US

V. Phone/Fax

Practice location:
  • Phone: 617-327-6560
  • Fax:
Mailing address:
  • Phone: 857-203-6638
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number231123
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number231123
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: