Organization
MGH REVERE HEALTHCARE CENTRE
Active
Parent organization
MASSACHUSETTS GENERAL HOSPITAL
Organization subpart
Yes
Provider details
NPI number
Legal business name
MASSACHUSETTS GENERAL HOSPITAL
Authorized official
RUCHITA VORA PT, MSPT (STAFF PHYSICAL THERAPIST)
17814856222
Entity
Organization
Contact information
Practice address
300 OCEAN AVE, REVERE, MA 02151-3675
(781) 485-6222
(781) 485-6232
Mailing address
190 MOUNTAIN AVE, APT # 404, MALDEN, MA 02148-2762
(508) 615-9191
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
18434
MA
Other
Enumeration date
07/16/2009
Last updated
07/16/2009
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