Basic Information
| Provider Information | |||||||||
| NPI: | 1841250461 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | RAINA | ||||||||
| FirstName: | ABHISHAKE | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 18 WASHINGTON ST | ||||||||
| Address2: | |||||||||
| City: | FOXBORO | ||||||||
| State: | MA | ||||||||
| PostalCode: | 020351021 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5086980044 | ||||||||
| FaxNumber: | 5086985373 | ||||||||
| Practice Location | |||||||||
| Address1: | 202 POMFRET ST | ||||||||
| Address2: | |||||||||
| City: | PUTNAM | ||||||||
| State: | CT | ||||||||
| PostalCode: | 062601833 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8609637917 | ||||||||
| FaxNumber: | 8609630018 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/27/2006 | ||||||||
| LastUpdateDate: | 05/21/2014 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 230317 | MA | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | 44686 | CT | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.