Unknown Individual – Family Medicine Physician, NPI 1164409462
Family Medicine Physician
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NPPES metrics only — not quality of care.
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Provider Addresses for Unknown Individual
5, Neponset Street, Worcester, Worcester County, Massachusetts, 01606, United States
WOT 2ND FL, STE C203
WORCESTER, MA 016062714
Phone: (978) 466-3208
Fax: (978) 840-1680
Type: Mailing
New Lancaster Road, Gates Crossing, Leominster, Worcester County, Massachusetts, 01453-3312, United States
LEOMINSTER, MA 014534958
Phone: (978) 466-3208
Fax: (978) 840-1680
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
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Medicare Enrollment & Revalidation
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No Medicare enrollment or revalidation data available for this provider in our database.
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Medicare Utilization (FFS)
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No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 01606)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| FAMILY MEDICINE | MA | 90670 | Pneumococcal vaccine for injection into muscle | 21 | 21 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| D E R M A T O L O G Y | MA | |
| Internal Medicine | MA | |
| - | MA | |
| - | MA | |
| Emergency Medicine | MA | |
| Physical Therapist In Private Practice | MA | |
| Physician Assistant | MA | |
| Family Practice | MA | |
| Clinical Psychologist | MA | |
| - | MA |
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