Provider Demographics
NPI:1548764798
Name:IORA HEALTH MASSACHUSETTS PC
Entity Type:Organization
Organization Name:IORA HEALTH MASSACHUSETTS PC
Other - Org Name:IORA PRIMARY CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RUSHIKA
Authorized Official - Middle Name:
Authorized Official - Last Name:FERNANDOPULLE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:617-454-4672
Mailing Address - Street 1:101 TREMONT ST FL 6
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02108-5004
Mailing Address - Country:US
Mailing Address - Phone:617-454-4672
Mailing Address - Fax:617-701-7740
Practice Address - Street 1:489 BEARSES WAY
Practice Address - Street 2:
Practice Address - City:HYANNIS
Practice Address - State:MA
Practice Address - Zip Code:02601-2707
Practice Address - Country:US
Practice Address - Phone:508-771-4092
Practice Address - Fax:508-771-9466
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-22
Last Update Date:2018-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty