Healthcare Provider Details

I. General information

NPI: 1013228022
Provider Name (Legal Business Name): ABRAHAM COHEN BUCAY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/24/2010
Last Update Date: 10/22/2026
Certification Date: 10/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55 LAKE AVE N
WORCESTER MA
01655-0002
US

IV. Provider business mailing address

55 FRUIT ST
BOSTON MA
02114-2621
US

V. Phone/Fax

Practice location:
  • Phone: 508-334-3155
  • Fax:
Mailing address:
  • Phone: 617-726-5050
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number281822
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: