Mirvoda, Svetlana

Mirvoda, Svetlana is an individual health care provider with primary practice located at 20 Linden St Ste 1 , Allston MA 02134-1776. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as her primary health care specialty. Mirvoda, Svetlana can be contacted via phone (617) 787-0030.

Contact Information

Primary practice address
20 Linden St Ste 1 Allston MA 02134-1776
Phone: (617) 787-0030
Fax: (617) 787-0010
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X 10206 Massachusetts

Profile Details

NPI number 1720102452
LBN Legal business name Mirvoda, Svetlana
Credentials Registered Physical Therapist (RPT)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 19th, 2007
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1720102452 NPPES
Massachusetts MEDICAID 0305901
Massachusetts Other Y68554

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