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General NPI Number Information
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NPI Number | 1043486632
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Entity Type | Individual
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Provider Name | RITU BAGLA MD
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Gender | Female
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Dates
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Enumeration Date | 05/02/2008
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Last Update Date | 05/03/2019
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Provider Practice Location Address
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Address Line | 41 MALL RD LAHEY CLINIC DEPARTMENT OF NEUROLOGY
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City | BURLINGTON
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State | MA
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Zip | 01805-0001
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Country | US
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Telephone | 781-744-8630
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Fax | 781-744-5581
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Provider Business Mailing Address
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Address Line | 41 MALL RD LAHEY CLINIC
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City | BURLINGTON
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State | MA
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Zip | 01805-0001
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Country | US
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Telephone | 781-744-8771
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Fax | 781-744-2905
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | MT180526
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 237362
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License Number State | MA
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Taxonomy #3
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Taxonomy Code | 2084N0600X
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Taxonomy Name | Clinical Neurophysiology Physician
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License Number | 237362
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License Number State | MA
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