Provider Demographics
NPI:1811263007
Name:BEN DOR, RIVKA RIVI
Entity type:Individual
Prefix:DR
First Name:RIVKA
Middle Name:RIVI
Last Name:BEN DOR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22616 GATEWAY CENTER DR
Mailing Address - Street 2:SUITE E
Mailing Address - City:CLARKSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20871-2011
Mailing Address - Country:US
Mailing Address - Phone:240-826-8600
Mailing Address - Fax:240-826-8610
Practice Address - Street 1:14915 BROSCHART RD STE 2200
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-3350
Practice Address - Country:US
Practice Address - Phone:301-838-4912
Practice Address - Fax:301-251-4666
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-01
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD00807472084P0800X, 261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health