Healthcare Provider Details

I. General information

NPI: 1780148924
Provider Name (Legal Business Name): BENITA KUMAR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/22/2019
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33 LYMAN ST STE 103B
WESTBOROUGH MA
01581-5403
US

IV. Provider business mailing address

28 HARRINGTON FARMS WAY
SHREWSBURY MA
01545-4035
US

V. Phone/Fax

Practice location:
  • Phone: 774-393-1849
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number15218
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: