Provider Demographics
NPI:1710722616
Name:ANEZ BRUZUAL, ISABEL CRISTINA (MS, CGC)
Entity type:Individual
Prefix:
First Name:ISABEL
Middle Name:CRISTINA
Last Name:ANEZ BRUZUAL
Suffix:
Gender:F
Credentials:MS, CGC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 LEIGHTON ST UNIT 515
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02141-2419
Mailing Address - Country:US
Mailing Address - Phone:617-955-2244
Mailing Address - Fax:
Practice Address - Street 1:150 BROOKLINE AVE
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02215-3930
Practice Address - Country:US
Practice Address - Phone:857-215-2373
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-01
Last Update Date:2024-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAGC10032170300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS