=====================================================
General NPI Number Information
=====================================================
NPI Number | 1487428553
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | WORCESTER REFUGEE AND IMMIGRANT SUPPORT AND EMPOWERMENT RISE FOR HEALTH
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/09/2023
-----------------------------------------------------
Last Update Date | 11/21/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 18 CHESTNUT ST STE 230
-----------------------------------------------------
City | WORCESTER
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 01608-1557
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 774-417-1756
-----------------------------------------------------
Fax | 508-365-6103
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 18 CHESTNUT ST STE 230
-----------------------------------------------------
City | WORCESTER
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 01608-1557
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 774-417-1756
-----------------------------------------------------
Fax | 508-365-6103
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | EXECUTIVE DIRECTOR
-----------------------------------------------------
Name | OLGA VALDMAN
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 617-529-4978
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207Q00000X
-----------------------------------------------------
Taxonomy Name | Family Medicine Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------