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General NPI Number Information
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NPI Number | 1013454016
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Entity Type | Individual
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Provider Name | RITA ONYERO AGHOLOR
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Gender | Female
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Dates
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Enumeration Date | 01/27/2017
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Last Update Date | 04/13/2018
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Provider Practice Location Address
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Address Line | 5 MIDDLESEX AVE
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City | SOMERVILLE
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State | MA
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Zip | 02145-1102
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Country | US
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Telephone | 617-623-3211
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Fax |
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Provider Business Mailing Address
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Address Line | 37 TROUT BROOK AVE
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City | MILTON
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State | MA
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Zip | 02186-2503
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Country | US
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Telephone | 617-806-6262
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 263132
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License Number State | MA
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