Healthcare Provider Details

I. General information

NPI: 1184687568
Provider Name (Legal Business Name): ARIANA JESSICA VORA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/07/2006
Last Update Date: 06/17/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

65 WALNUT ST SPAULDING NEWTON WELLESLEY REHAB CENTER
WELLESLEY MA
02481
US

IV. Provider business mailing address

PO BOX 9142 MASS GENERAL PHYSICIAN ORGANIZATION
CHARLESTOWN MA
02129-9142
US

V. Phone/Fax

Practice location:
  • Phone: 781-431-9144
  • Fax: 781-431-9152
Mailing address:
  • Phone: 617-643-2420
  • Fax: 617-726-7875

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number226358
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code2081S0010X
TaxonomySports Medicine (Physical Medicine & Rehabilitation) Physician
License Number228358
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: