Provider Demographics
NPI:1174649750
Name:CAGANDA, ROBERTO ELIAS MADARA JR (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERTO ELIAS
Middle Name:MADARA
Last Name:CAGANDA
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:ROEL
Other - Middle Name:MADARA
Other - Last Name:CAGANDA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:151 EVERETT AVE
Mailing Address - Street 2:MGH CHELSEA HEALTH CENTER - URGENT CARE
Mailing Address - City:CHELSEA
Mailing Address - State:MA
Mailing Address - Zip Code:02150-1812
Mailing Address - Country:US
Mailing Address - Phone:617-884-8302
Mailing Address - Fax:617-887-3704
Practice Address - Street 1:151 EVERETT AVE
Practice Address - Street 2:MGH CHELSEA HEALTH CENTER - URGENT CARE
Practice Address - City:CHELSEA
Practice Address - State:MA
Practice Address - Zip Code:02150-1812
Practice Address - Country:US
Practice Address - Phone:617-884-8302
Practice Address - Fax:617-887-3704
Is Sole Proprietor?:No
Enumeration Date:2007-03-22
Last Update Date:2012-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC7-0003033207Q00000X
IL036119315207Q00000X
MA238012207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine