Individual
RITA KHODOSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D./PH.D.
Contact information
Practice address
281 LINCOLN ST, WORCESTER, MA 01605-2138
(508) 334-5979
(508) 334-5232
Mailing address
PO BOX 415348, BOSTON, MA 02241-5348
(800) 225-8885
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
A105860
CA
207N00000X
Dermatology Physician
Primary
T289320
MA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/30/2008
Last updated
09/02/2021
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