Healthcare Provider Details

I. General information

NPI: 1174456693
Provider Name (Legal Business Name): VIM MEDICINE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2026
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40 GROVE ST STE 410
WELLESLEY MA
02482-7768
US

IV. Provider business mailing address

4 LYNN ST
NATICK MA
01760-3321
US

V. Phone/Fax

Practice location:
  • Phone: 617-402-3087
  • Fax:
Mailing address:
  • Phone: 617-402-3087
  • Fax: 617-691-5246

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: RICHARD JOSEPH
Title or Position: FOUNDER
Credential: MD
Phone: 203-640-0019