Healthcare Provider Details

I. General information

NPI: 1225496532
Provider Name (Legal Business Name): ELADIO ARROYO MSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/01/2016
Last Update Date: 02/01/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11 SYCAMORE ST
WORCESTER MA
01608-2213
US

IV. Provider business mailing address

382 B #14 SUNDERLAND ROAD
WORCESTER MA
01604
US

V. Phone/Fax

Practice location:
  • Phone: 508-798-1900
  • Fax:
Mailing address:
  • Phone: 508-665-8334
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number11545
License Number StatePR

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: