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General NPI Number Information
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NPI Number | 1063377729
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Entity Type | Individual
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Provider Name | SHARENE NANA ADOMA
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Gender | Female
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Dates
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Enumeration Date | 12/16/2025
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Last Update Date | 12/16/2025
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Provider Practice Location Address
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Address Line | 48 ELM ST STE 1
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City | WORCESTER
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State | MA
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Zip | 01609-2545
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Country | US
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Telephone | 508-225-6634
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Fax |
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Provider Business Mailing Address
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Address Line | 11 ESTHER ST APT 1
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City | WORCESTER
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State | MA
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Zip | 01607-1037
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Country | US
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Telephone | 631-829-7424
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2080P0008X
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Taxonomy Name | Pediatric Neurodevelopmental Disabilities Physician
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License Number | SA1050399
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License Number State | MA
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