Provider Demographics
NPI:1396882536
Name:MEDAGODA, RUMALI S (MD)
Entity type:Individual
Prefix:DR
First Name:RUMALI
Middle Name:S
Last Name:MEDAGODA
Suffix:
Gender:F
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:CENTRAL MASS ALLERGY
Mailing Address - Street 2:425 N LAKE AVE
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01605-5702
Mailing Address - Country:US
Mailing Address - Phone:508-757-1589
Mailing Address - Fax:918-307-2454
Practice Address - Street 1:CENTRAL MASS ALLERGY
Practice Address - Street 2:425 N LAKE AVE STE 201
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01605-0160
Practice Address - Country:US
Practice Address - Phone:508-757-1589
Practice Address - Fax:508-756-5633
Is Sole Proprietor?:No
Enumeration Date:2007-01-30
Last Update Date:2023-05-05
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Provider Licenses
StateLicense IDTaxonomies
OK24097208000000X
MA2916172080P0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0201XAllopathic & Osteopathic PhysiciansPediatricsPediatric Allergy/Immunology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics