Healthcare Provider Details

I. General information

NPI: 1467019406
Provider Name (Legal Business Name): TONYA MARIE PADGETT-COMISKA RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/24/2019
Last Update Date: 05/24/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26 QUEEN ST
WORCESTER MA
01610-2473
US

IV. Provider business mailing address

107 HAMILTON ST APT 3
WORCESTER MA
01604-2252
US

V. Phone/Fax

Practice location:
  • Phone: 508-373-7855
  • Fax:
Mailing address:
  • Phone: 774-253-2306
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License Number2314893
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: