Healthcare Provider Details

I. General information

NPI: 1831027655
Provider Name (Legal Business Name): MAURICE NDANSI
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/12/2026
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33 WALDO ST STE 2
WORCESTER MA
01608-1535
US

IV. Provider business mailing address

33 WALDO ST STE 2
WORCESTER MA
01608-1535
US

V. Phone/Fax

Practice location:
  • Phone: 978-578-2762
  • Fax:
Mailing address:
  • Phone: 978-578-2762
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: