Healthcare Provider Details

I. General information

NPI: 1285730671
Provider Name (Legal Business Name): SERGEY WORTMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/15/2006
Last Update Date: 12/10/2025
Certification Date: 12/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 WELBY RD STE 1E
NEW BEDFORD MA
02745-1137
US

IV. Provider business mailing address

1 WELBY RD STE 1E
NEW BEDFORD MA
02745-1137
US

V. Phone/Fax

Practice location:
  • Phone: 508-998-8517
  • Fax: 774-328-9929
Mailing address:
  • Phone: 508-998-8517
  • Fax: 774-328-9929

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number152325
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: