Provider Demographics
NPI:1144462185
Name:BECKMAN, RITA J (NP)
Entity type:Individual
Prefix:MS
First Name:RITA
Middle Name:J
Last Name:BECKMAN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:RITA
Other - Middle Name:J
Other - Last Name:BECKMAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:NP
Mailing Address - Street 1:133 BROOKLINE AVE
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02215-3904
Mailing Address - Country:US
Mailing Address - Phone:617-421-1194
Mailing Address - Fax:617-421-1187
Practice Address - Street 1:133 BROOKLINE AVE
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02215-3904
Practice Address - Country:US
Practice Address - Phone:617-421-1194
Practice Address - Fax:617-421-1187
Is Sole Proprietor?:No
Enumeration Date:2009-04-06
Last Update Date:2014-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA153669363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health