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NPI Code Detail

MEDICARE: DIBEL PRIETO

MEDICARE: DIBEL PRIETO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1477057636
Entity Type Code : Individual
Provider Name (Legal Business Name) : DIBEL PRIETO
Provider Business Mailing Address
First Line : 302 EUSTIS ST
Second Line :
City : ROXBURY
State : MA
Zip : 02119-3800
Country : US
Telephone Number : 617-445-1123
Fax Number :
Provider Business Practice Location Address
First Line : 302 EUSTIS ST
Second Line :
City : ROXBURY
State : MA
Zip : 02119-3800
Country : US
Telephone Number : 617-445-1123
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/22/2018
Last Update Date : 03/22/2018

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Directions to “ DIBEL PRIETO ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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