Individual
RICHARD PRUDENCIO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1575 CAMBRIDGE ST, CAMBRIDGE, MA 02138-4308
(617) 876-4344
(617) 234-7950
Mailing address
289 HIGHLAND AVE, 108, SOMERVILLE, MA 02144-3209
(617) 876-4344
(617) 234-7950
Taxonomy
Speciality
Code
Description
License number
State
283X00000X
Rehabilitation Hospital
Primary
223241
MA
Other
Enumeration date
11/15/2006
Last updated
11/30/2021
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