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General NPI Number Information
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NPI Number | 1770027492
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Entity Type | Organization
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Legal Business Name | BENJAMIN, RONALD
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Dates
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Enumeration Date | 12/14/2016
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Last Update Date | 12/14/2016
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Provider Practice Location Address
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Address Line | 172 CUSHING ST
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City | CAMBRIDGE
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State | MA
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Zip | 02138-4582
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Country | US
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Telephone | 617-460-7494
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Fax | 858-309-3397
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Provider Business Mailing Address
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Address Line | 172 CUSHING ST
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City | CAMBRIDGE
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State | MA
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Zip | 02138-4582
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Country | US
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Telephone | 617-460-7494
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Fax | 858-309-3397
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICE
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Name | MR. RONALD BENJAMIN
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Credential | MA
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Telephone | 617-460-7494
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State | MA
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