Provider Demographics
NPI:1235321548
Name:REKHA BAINS M.D., PC
Entity Type:Organization
Organization Name:REKHA BAINS M.D., PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:REKHA
Authorized Official - Middle Name:
Authorized Official - Last Name:BAINS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:978-452-4666
Mailing Address - Street 1:275 VARNUM AVE
Mailing Address - Street 2:SUITE 108
Mailing Address - City:LOWELL
Mailing Address - State:MA
Mailing Address - Zip Code:01854-2141
Mailing Address - Country:US
Mailing Address - Phone:978-452-1666
Mailing Address - Fax:978-452-1780
Practice Address - Street 1:275 VARNUM AVE
Practice Address - Street 2:SUITE 108
Practice Address - City:LOWELL
Practice Address - State:MA
Practice Address - Zip Code:01854-2141
Practice Address - Country:US
Practice Address - Phone:978-452-1666
Practice Address - Fax:978-452-1780
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-10
Last Update Date:2007-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA74928208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3091716Medicaid
MA074928OtherTUFTS HEALTH PLAN
MAM18901OtherBLUE CROSS BLUE SHIELD
MAF23709OtherUPIN