Provider Demographics
NPI:1821359373
Name:DEBARI, ELIZABETH A
Entity Type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:A
Last Name:DEBARI
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 1:100 FULTON ST
Mailing Address - Street 2:4T
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02109-1446
Mailing Address - Country:US
Mailing Address - Phone:508-380-9456
Mailing Address - Fax:
Practice Address - Street 1:100 FULTON ST
Practice Address - Street 2:4T
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02109-1446
Practice Address - Country:US
Practice Address - Phone:508-380-9456
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-31
Last Update Date:2012-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program