MEDICARE: MR. GABRIEL BENJAMIN DODENHOFF

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	172V00000X	Community Health Worker	CHW00516	MA

General Provider Information

NPI Number	:	1194478834
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. GABRIEL BENJAMIN DODENHOFF

Provider Business Mailing Address
First Line	:	607 PLEASANT ST STE 115
Second Line	:
City	:	ATTLEBORO
State	:	MA
Zip	:	02703-2570
Country	:	US
Telephone Number	:	508-223-4691
Fax Number	:

Provider Business Practice Location Address
First Line	:	607 PLEASANT ST STE 115
Second Line	:
City	:	ATTLEBORO
State	:	MA
Zip	:	02703-2570
Country	:	US
Telephone Number	:	774-218-8158
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/02/2022
Last Update Date	:	05/04/2026

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Directions to “ MR. GABRIEL BENJAMIN DODENHOFF ” Practice Location

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