Provider Demographics
NPI:1346070745
Name:DR CLINICAL RESOURCES
Entity type:Organization
Organization Name:DR CLINICAL RESOURCES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:RIDIANE
Authorized Official - Middle Name:
Authorized Official - Last Name:DENIS
Authorized Official - Suffix:
Authorized Official - Credentials:BS,RN,MD
Authorized Official - Phone:877-770-6671
Mailing Address - Street 1:PO BOX 186
Mailing Address - Street 2:
Mailing Address - City:MALDEN
Mailing Address - State:MA
Mailing Address - Zip Code:02148-0002
Mailing Address - Country:US
Mailing Address - Phone:877-770-6671
Mailing Address - Fax:
Practice Address - Street 1:868 SALEM ST
Practice Address - Street 2:
Practice Address - City:MALDEN
Practice Address - State:MA
Practice Address - Zip Code:02148-4436
Practice Address - Country:US
Practice Address - Phone:617-959-7561
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-01
Last Update Date:2024-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251F00000XAgenciesHome Infusion
No253Z00000XAgenciesIn Home Supportive Care
No291U00000XLaboratoriesClinical Medical Laboratory
No385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child
No385HR2065XRespite Care FacilityRespite CareRespite Care, Physical Disabilities, Child