1942407606 NPI number — RICHARD N WALDMAN MD PC

Table of content: (NPI 1942407606)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1942407606 NPI number — RICHARD N WALDMAN MD PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
RICHARD N WALDMAN MD PC
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:
1942407606
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/19/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
235 HANOVER ST
Provider Second Line Business Mailing Address:
SUITE 308
Provider Business Mailing Address City Name:
FALL RIVER
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02720-5246
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
508-679-7361
Provider Business Mailing Address Fax Number:
508-679-7702

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
235 HANOVER ST
Provider Second Line Business Practice Location Address:
SUITE 308
Provider Business Practice Location Address City Name:
FALL RIVER
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02720-5246
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
508-679-7361
Provider Business Practice Location Address Fax Number:
508-679-7702
Provider Enumeration Date:
06/27/2007

Additional Information

Authorized Official

Authorized Official Last Name:
KARPPINEN
Authorized Official First Name:
LINDA
Authorized Official Middle Name:
L
Authorized Official Title or Position:
OFFICE MANAGER
Authorized Official Telephone Number:
508-679-7361

Provider Taxonomy Codes

  • Taxonomy code: 207N00000X , with the licence number:  42776 , 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: 03-01007 . This is a "UNITED HEALTH" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: B20459501 . This is a "CIGNA" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: M14936 . This is a "BLUECROSS" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 2061988 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 4030 . This is a "HARVARD PILGRIM HEALTH" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 81277 . This is a "AETNA LIFE" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 202428 . This is a "HMORI" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: K08334 . This is a "HMOB" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 9759301 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 042776 . This is a "TUFTS" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 4674-5 . This is a "RIBS" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".




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