Healthcare Provider Details

I. General information

NPI: 1861452294
Provider Name (Legal Business Name): JOSEPH J SLIWKOWSKI JR. MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/28/2006
Last Update Date: 10/29/2026
Certification Date: 10/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

366 SHREWSBURY ST
WORCESTER MA
01604-4647
US

IV. Provider business mailing address

366 SHREWSBURY ST
WORCESTER MA
01604-4647
US

V. Phone/Fax

Practice location:
  • Phone: 508-595-2700
  • Fax: 774-221-5136
Mailing address:
  • Phone: 508-595-2700
  • Fax: 774-221-5136

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083S0010X
TaxonomySports Medicine (Preventive Medicine) Physician
License Number74311
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number74311
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: