Individual
EILEEN RIDGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
105 VICTORY RD, DORCHESTER, MA 02122-3518
(617) 371-3010
Mailing address
111 GLENWAY ST, DORCHESTER, MA 02121-4109
(857) 540-0999
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
Primary
RN233923
MA
Other
Enumeration date
06/25/2018
Last updated
06/25/2018
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