1235111303 NPI number — A. MICHELE RICARD MD

Table of content: A. MICHELE RICARD MD (NPI 1235111303)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1235111303 NPI number — A. MICHELE RICARD MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
RICARD
Provider First Name:
A.
Provider Middle Name:
MICHELE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
RICARD
Provider Other First Name:
ANN
Provider Other Middle Name:
MICHELE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
MD
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1235111303
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/08/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1070
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BERLIN
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
01503-2070
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
978-771-2343
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
124 PLEASANT STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BERLIN
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
01503-2070
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
978-771-2343
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/15/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , with the licence number:  38517 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 042472266 . This is a "PRIVATE HEALTHCARE SYSTEM" identifier . This identifiers is of the category "OTHER".
  • Identifier: 042472266008 . This is a "TRICARE/CHAMPUS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 45519 . This is a "HEALTHY START" identifier . This identifiers is of the category "OTHER".
  • Identifier: 4582679 . This is a "AETNA/US HEALTHCARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 784076 . This is a "MVP HEALTH CARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0101699 . This is a "MEDICAID/WELFARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: B22015 . This is a "MEDICARE B" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0404598 . This is a "EVERCARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 042472266 . This is a "ONE HEALTH PLAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 380001952 . This is a "RAILROAD MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 45519 . This is a "CHILDRENS MED SECURITY PL" identifier . This identifiers is of the category "OTHER".
  • Identifier: 4768 . This is a "FALLON COMMUNITY HLTH PL" identifier . This identifiers is of the category "OTHER".
  • Identifier: 042472266 . This is a "THREE RIVERS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2105073 . This is a "FIRST HEALTH" identifier . This identifiers is of the category "OTHER".
  • Identifier: AA2365 . This is a "HARVARD PILGRIM HEALTHCAR" identifier . This identifiers is of the category "OTHER".
  • Identifier: B22015 . This is a "BLUE SHIELD HMO BLUE" identifier . This identifiers is of the category "OTHER".
  • Identifier: B22015 . This is a "BLUE CARE ELECT" identifier . This identifiers is of the category "OTHER".
  • Identifier: B22015 . This is a "BLUE SHIELD INDEMNITY" identifier . This identifiers is of the category "OTHER".




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