Provider Demographics
NPI:1396720348
Name:WORCESTER COUNTY ORTHOPEDICS
Entity type:Organization
Organization Name:WORCESTER COUNTY ORTHOPEDICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:J
Authorized Official - Last Name:MURRAY
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:508-755-1208
Mailing Address - Street 1:59 QUINSIGAMOND AVE
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01610-1806
Mailing Address - Country:US
Mailing Address - Phone:508-755-1208
Mailing Address - Fax:508-755-5640
Practice Address - Street 1:59 QUINSIGAMOND AVE
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01610-1806
Practice Address - Country:US
Practice Address - Phone:508-755-1208
Practice Address - Fax:508-755-5640
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA9724231Medicaid
MAWOM21114Medicare ID - Type Unspecified