| 360 Healthcare Llc | |
|
67 S Bedford St Ste 400w Burlington MA 01803-5177 | |
| (781) 488-6843 | |
| (781) 488-6837 |
| Full Name | 360 Healthcare Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 67 S Bedford St Ste 400w, Burlington, Massachusetts |
| Authorized Official Name and Position | Faisal Malik (AUTHORIZED OFFICIAL) |
| Authorized Official Contact | 7815471038 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| 360 Healthcare Llc 67 S Bedford St Ste 400w Burlington MA 01803-5177 Ph: (781) 488-6843 | 360 Healthcare Llc 67 S Bedford St Ste 400w Burlington MA 01803-5177 Ph: (781) 488-6843 |
| NPI Number | 1841919297 |
|---|---|
| Provider Enumeration Date | 08/26/2022 |
| Last Update Date | 08/26/2022 |
| Medicare PECOS PAC ID | 5597131532 |
|---|---|
| Medicare Enrollment ID | O20221017002563 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841919297 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Rishi Likhi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1497927388 PECOS PAC ID: 2466510011 Enrollment ID: I20081025000115 |
| Provider Name | Faisal Malik |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1912106691 PECOS PAC ID: 3870649304 Enrollment ID: I20090924000075 |
| Provider Name | Udaya Sena Reddy Dendi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1992968200 PECOS PAC ID: 0143345421 Enrollment ID: I20120301000900 |
| Provider Name | Parag Vohra |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1073749412 PECOS PAC ID: 5092860858 Enrollment ID: I20140918000642 |
| Provider Name | Kerrill J Mulvaney |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194180281 PECOS PAC ID: 1850688607 Enrollment ID: I20160922001842 |
| Provider Name | Phyllis Chinyanga-edouard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295261782 PECOS PAC ID: 2961760160 Enrollment ID: I20171218000013 |
| Provider Name | Devi Sivanandan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407460322 PECOS PAC ID: 4587082656 Enrollment ID: I20200922002242 |
| Provider Name | Mayra Bolden |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073074464 PECOS PAC ID: 4082034996 Enrollment ID: I20201014003699 |
| Provider Name | Shannon Margaret Hurley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477146025 PECOS PAC ID: 6507267465 Enrollment ID: I20210629002715 |
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