Healthcare Provider Details

I. General information

NPI: 1689316283
Provider Name (Legal Business Name): NOVELLA MEDICINE SERVICES OF MASSACHUSETTS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/13/2022
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

416 BELMONT ST STE 206
WORCESTER MA
01604-1086
US

IV. Provider business mailing address

1111B S GOVERNORS AVE STE 3887
DOVER DE
19904-6903
US

V. Phone/Fax

Practice location:
  • Phone: 603-836-9869
  • Fax:
Mailing address:
  • Phone: 508-433-3687
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ROBERT AMORY THORNDIKE
Title or Position: MANAGER
Credential:
Phone: 781-724-5916