Provider Demographics
NPI:1407537574
Name:RIBEIRO, ROSANA ALVES
Entity Type:Individual
Prefix:
First Name:ROSANA
Middle Name:ALVES
Last Name:RIBEIRO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:488 BOSTON POST RD E STE D
Mailing Address - Street 2:
Mailing Address - City:MARLBOROUGH
Mailing Address - State:MA
Mailing Address - Zip Code:01752-3608
Mailing Address - Country:US
Mailing Address - Phone:774-386-0580
Mailing Address - Fax:
Practice Address - Street 1:488 BOSTON POST RD E STE D
Practice Address - Street 2:
Practice Address - City:MARLBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:01752-3608
Practice Address - Country:US
Practice Address - Phone:774-386-0580
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-31
Last Update Date:2023-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA16101225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist