NPI 1023579349 · live from the CMS NPI Registry
Shivkumar Bhadola
Psychiatry & Neurology, Neurology in Worcester, MA. National Provider Identifier 1023579349, active.
NPI record
| NPI | 1023579349 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Psychiatry & Neurology, Neurology 2084N0400X |
| Practice location | 55 Lake Ave N, Worcester, MA 01655 |
| Practice phone | 617-414-5951 |
| Mailing address | Po Box 415348, Boston, MA 02241 |
| Enumerated | March 28, 2019 |
| Last updated | October 14, 2024 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Psychiatry & Neurology, Neurology primary | 2084N0400X | 1019345 (MA) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.