Healthcare Provider Details
I. General information
NPI: 1962346031
Provider Name (Legal Business Name): YOHAN JOE ROY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 04/17/2026
Last Update Date: 04/17/2026
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
ST VINCENT HOSPITAL 123 SUMMER STREET
WORCESTER MA
01608
US
IV. Provider business mailing address
ST VINCENT HOSPITAL 123 SUMMER STREET
WORCESTER MA
01608
US
V. Phone/Fax
- Phone: 508-363-5000
- Fax:
- Phone: 508-363-5000
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 390200000X |
| Taxonomy | Student in an Organized Health Care Education/Training Program |
| License Number | |
| License Number State | MA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: