Healthcare Provider Details
I. General information
NPI: 1235894809
Provider Name (Legal Business Name): DIAGNOSIS NETWORK INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/08/2021
Last Update Date: 11/08/2021
Certification Date: 10/15/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
121 LINCOLN ST
WORCESTER MA
01605-2429
US
IV. Provider business mailing address
10 VINNIE WAY
SHREWSBURY MA
01545-4225
US
V. Phone/Fax
- Phone: 508-335-7163
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2085U0001X |
| Taxonomy | Diagnostic Ultrasound Physician |
| License Number | |
| License Number State | |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
VIII. Authorized Official
Name:
SHAHIDA
NAZ
BALAPARYA
Title or Position: PRESIDENT
Credential:
Phone: 508-335-7164