Basic Information
| Provider Information | |||||||||
| NPI: | 1659343739 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SIKKA | ||||||||
| FirstName: | RISHI | ||||||||
| MiddleName: | |||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 818 HARRISON AVE | ||||||||
| Address2: | DOWLING 1 SOUTH | ||||||||
| City: | BOSTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 021182645 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6174144849 | ||||||||
| FaxNumber: | 6174147759 | ||||||||
| Practice Location | |||||||||
| Address1: | 818 HARRISON AVE | ||||||||
| Address2: | DOWLING 1 SOUTH | ||||||||
| City: | BOSTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 021182645 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6174144849 | ||||||||
| FaxNumber: | 6174147759 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/03/2006 | ||||||||
| LastUpdateDate: | 07/19/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | 213920 | MA | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
ID Information
| ID | Type | State | Issuer | Description | 2003317 | 05 | MA | MEDICAID |