Provider Demographics
NPI:1467227686
Name:SPECIALISTVIRTUCARE PC
Entity Type:Organization
Organization Name:SPECIALISTVIRTUCARE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:JAVERIA
Authorized Official - Middle Name:
Authorized Official - Last Name:KOUSER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:508-740-9308
Mailing Address - Street 1:290 TURNPIKE RD
Mailing Address - Street 2:SUITE 150, BOX 374
Mailing Address - City:WESTBOROUGH
Mailing Address - State:MA
Mailing Address - Zip Code:01581-2843
Mailing Address - Country:US
Mailing Address - Phone:508-740-9308
Mailing Address - Fax:
Practice Address - Street 1:290 TURNPIKE RD STE 150
Practice Address - Street 2:
Practice Address - City:WESTBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:01581-2843
Practice Address - Country:US
Practice Address - Phone:508-740-9308
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-17
Last Update Date:2024-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty