Healthcare Provider Details

I. General information

NPI: 1750646451
Provider Name (Legal Business Name): DR. DAVID S HEALEY
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/09/2012
Last Update Date: 01/14/2024
Certification Date: 01/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26 QUEEN ST.
WORCESTER MA
01610-2473
US

IV. Provider business mailing address

26 QUEEN STREET
WORCESTER MA
01610-2473
US

V. Phone/Fax

Practice location:
  • Phone: 508-860-7700
  • Fax:
Mailing address:
  • Phone: 617-513-6938
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD17420
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: