Healthcare Provider Details
I. General information
NPI: 1265046148
Provider Name (Legal Business Name): KRIPA BEHAVIORAL HEALTH, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/08/2020
Last Update Date: 09/08/2020
Certification Date: 09/08/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
415 ELSBREE ST STE 1A
FALL RIVER MA
02720-7297
US
IV. Provider business mailing address
415 ELSBREE ST STE 1A
FALL RIVER MA
02720-7297
US
V. Phone/Fax
- Phone: 508-974-4112
- Fax: 508-535-8021
- Phone: 508-974-4112
- Fax: 508-535-8021
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2084P0800X |
| Taxonomy | Psychiatry Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
SHALINI
MANSHARAMANI
Title or Position: PRESIDENT
Credential: MD
Phone: 508-974-4112