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General NPI Number Information
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NPI Number | 1386249332
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Entity Type | Individual
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Provider Name | DOROTHY KAYE DECUBELLIS FNP
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Gender | Female
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Dates
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Enumeration Date | 11/30/2020
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Last Update Date | 02/03/2023
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Provider Practice Location Address
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Address Line | 123 SUMMER ST
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City | WORCESTER
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State | MA
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Zip | 01608-1216
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Country | US
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Telephone | 508-363-7449
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Fax | 508-363-7512
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Provider Business Mailing Address
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Address Line | 47 CENTRAL ST
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City | SOUTHBOROUGH
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State | MA
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Zip | 01745-1003
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Country | US
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Telephone | 617-671-8052
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | RN2274954
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | RN2274954
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License Number State | MA
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