Healthcare Provider Details

I. General information

NPI: 1093599540
Provider Name (Legal Business Name): LOIS DWIRA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/23/2023
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26 QUEEN STREET
WORCESTER MA
01610-2473
US

IV. Provider business mailing address

26 QUEEN STREET
WORCESTER MA
01610-2473
US

V. Phone/Fax

Practice location:
  • Phone: 508-860-7800
  • Fax: 508-661-3046
Mailing address:
  • Phone: 508-860-7800
  • Fax: 508-661-3046

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberRN2336465
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: