1912296633 NPI number — HARBOR MEDICAL ASSOCIATES P.C.

Table of content: KAIRA RODRIGUEZ BENITEZ DC (NPI 1275345126)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1912296633 NPI number — HARBOR MEDICAL ASSOCIATES P.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HARBOR MEDICAL ASSOCIATES P.C.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1912296633
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/13/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
541 MAIN ST
Provider Second Line Business Mailing Address:
SUITE 414
Provider Business Mailing Address City Name:
SOUTH WEYMOUTH
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02190-1868
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
781-952-1433
Provider Business Mailing Address Fax Number:
508-630-2462

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
541 MAIN ST
Provider Second Line Business Practice Location Address:
SUITE 414
Provider Business Practice Location Address City Name:
SOUTH WEYMOUTH
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02190-1868
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
781-952-1433
Provider Business Practice Location Address Fax Number:
508-630-2462
Provider Enumeration Date:
04/04/2011

Additional Information

Authorized Official

Authorized Official Last Name:
GRAPE
Authorized Official First Name:
PETER
Authorized Official Middle Name:
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
781-952-1249

Provider Taxonomy Codes

  • Taxonomy code: 261QU0200X , with the licence number:  77770 , 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)





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