Healthcare Provider Details

I. General information

NPI: 1497927388
Provider Name (Legal Business Name): RISHI LIKHI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2008
Last Update Date: 08/28/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

170 GOVERNORS AVE
MEDFORD MA
02155-1643
US

IV. Provider business mailing address

170 GOVERNORS AVE
MEDFORD MA
02155-1643
US

V. Phone/Fax

Practice location:
  • Phone: 781-306-6081
  • Fax:
Mailing address:
  • Phone: 781-306-6081
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number234878
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: