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General NPI Number Information
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NPI Number | 1699043307
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Entity Type | Individual
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Provider Name | MARK C RIVINUS NP
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Gender | Male
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Dates
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Enumeration Date | 12/08/2011
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Last Update Date | 05/10/2026
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Provider Practice Location Address
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Address Line | 50 W MAIN ST
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City | HOPKINTON
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State | MA
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Zip | 01748-1672
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Country | US
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Telephone | 508-530-3140
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Fax | 603-893-8886
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Provider Business Mailing Address
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Address Line | 50 WEST MAIN ST
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City | HOPKINGTON
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State | MA
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Zip | 01748
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Country | US
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Telephone | 508-530-3140
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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 | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | RN148420
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | RN148420
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License Number State | MA
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