Healthcare Provider Details

I. General information

NPI: 1457789414
Provider Name (Legal Business Name): PROVIDERS WHO CARE PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/29/2013
Last Update Date: 10/29/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1853 COMMONWEALTH AVE SUITE 1
BRIGHTON MA
02135-5498
US

IV. Provider business mailing address

1853 COMMONWEALTH AVE SUITE 1
BRIGHTON MA
02135-5498
US

V. Phone/Fax

Practice location:
  • Phone: 617-254-3006
  • Fax: 617-254-3007
Mailing address:
  • Phone: 617-254-3006
  • Fax: 617-254-3007

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: ARKADI N. GATT
Title or Position: PRESIDENT
Credential: MS PAC
Phone: 617-877-2325