Healthcare Provider Details

I. General information

NPI: 1811092000
Provider Name (Legal Business Name): RIMAWI PEDIATRICS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/13/2006
Last Update Date: 11/22/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 WALNUT ST STE 102
WELLESLEY MA
02481
US

IV. Provider business mailing address

25 WALNUT ST SUITE 102
WELLESLEY MA
02481
US

V. Phone/Fax

Practice location:
  • Phone: 781-489-5546
  • Fax: 781-489-5769
Mailing address:
  • Phone: 781-489-5546
  • Fax: 781-489-5769

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number160607
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code2080P0006X
TaxonomyDevelopmental - Behavioral Pediatrics Physician
License Number160021
License Number StateMA

VIII. Authorized Official

Name: DR. LAMA RIMAWI
Title or Position: PRESIDENT
Credential: MD
Phone: 617-232-3132