Healthcare Provider Details

I. General information

NPI: 1518286129
Provider Name (Legal Business Name): SHISHIR KUMAR BATAJOO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/21/2010
Last Update Date: 04/22/2026
Certification Date: 04/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

85 PRESCOTT ST STE 403
WORCESTER MA
01605-2671
US

IV. Provider business mailing address

PO BOX 11760
BELFAST ME
04915-4008
US

V. Phone/Fax

Practice location:
  • Phone: 508-753-7259
  • Fax: 508-753-9577
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA8305
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: