Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | 212652 | MA |
N | 207QA0505X | Family Doctor - Adult Medicine | 019907 | GA |
NPI | 1154437010 |
---|---|
Provider Name | Dr. Rita P Wadhwani |
First Address | North Quincy, MA 02171-2122 |
Second Address | Quincy, MA 02169-1870 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/08/2006 |
Last Update Date | 17/11/2011 |