River Of Life Medical, LLC
Clinic/Center, Primary Care in Dorchester, Massachusetts
1710241245- Practice location
- 1370 Dorchester Ave Ste 21, Dorchester, MA 02122-2921
- Phone
- 617-596-1092
- Fax
- —
- Last updated
- June 29, 2012
River Of Life Medical, LLC is a healthcare organization based in Dorchester, MA. River Of Life Medical, LLC practices in Dorchester, MA. The NPI Number for River Of Life Medical, LLC is 1710241245 and holds a License No. 247965 (MA). The current practice location address for River Of Life Medical, LLC is 1370 Dorchester Ave Ste 21, Dorchester, MA 02122-2921 and can be reached out via phone at 617-596-1092.
Provider Profile Details
- NPI Number
- 1710241245
- Provider Name
- River Of Life Medical, LLC
- Provider Entity Type
- Organization
- Address
- 1370 Dorchester Ave Ste 21, Dorchester, MA 02122-2921
- Phone Number
- 617-596-1092
- Primary Taxonomy
- Clinic/Center, Primary Care · 261QP2300X
- Organization Subpart
- No
- Authorized Official
- Dr. Daniel Sanghyun Cagua-Koo, MD · Owner · 617-596-1092
- Provider Enumeration Date
- June 29, 2012
- Last Update Date
- June 29, 2012
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 1370 Dorchester Ave Ste 21
Dorchester, MA 02122-2921 - City
- Dorchester
- State
- Massachusetts
- Zip
- 02122-2921
- Phone Number
- 617-596-1092
Provider Business Mailing Address Details
- Address
- 1370 Dorchester Ave Ste 21
Dorchester, MA 02122-2921 - City
- Dorchester
- State
- MA
- Zip
- 02122-2921
License Information
- License Number
- 247965
- License State
- MA
- Taxonomy
- Clinic/Center, Primary Care · 261QP2300X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
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- Stephanie P De La Cruz-AriasInterpreter · NPI 1477453579
- Serena V Mcconkey, RN, BSNRegistered Nurse · NPI 1679473235
- Danaysia S Gomes-EvansDoula · NPI 1568362911
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Frequently Asked Questions
What is the NPI number of River Of Life Medical, LLC?
The NPI number of River Of Life Medical, LLC is 1710241245. It was assigned on June 29, 2012 and is currently active in the NPPES registry.
What is the specialty of River Of Life Medical, LLC?
River Of Life Medical, LLC is registered under the primary taxonomy Clinic/Center, Primary Care (code 261QP2300X), licensed in MA under license number 247965.
Where does River Of Life Medical, LLC practice?
The practice location is 1370 Dorchester Ave Ste 21, Dorchester, MA 02122-2921. The office can be reached at 617-596-1092 (phone).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1710241245 directly on the NPPES registry website.