Provider Demographics
NPI:1720309172
Name:IRBY, ANDREA YVETTE (HN)
Entity Type:Individual
Prefix:MRS
First Name:ANDREA
Middle Name:YVETTE
Last Name:IRBY
Suffix:
Gender:F
Credentials:HN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 EASTBROOK RD STE 201
Mailing Address - Street 2:
Mailing Address - City:DEDHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02026-2087
Mailing Address - Country:US
Mailing Address - Phone:781-302-4600
Mailing Address - Fax:781-329-4254
Practice Address - Street 1:20 EASTBROOK RD
Practice Address - Street 2:SUIT 201
Practice Address - City:DEDHAM
Practice Address - State:MA
Practice Address - Zip Code:02026-2075
Practice Address - Country:US
Practice Address - Phone:781-302-4600
Practice Address - Fax:781-329-4254
Is Sole Proprietor?:No
Enumeration Date:2010-06-21
Last Update Date:2010-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator