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General NPI Number Information
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NPI Number | 1487754974
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Entity Type | Individual
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Provider Name | MOHAMAD AMJAD BAHNASSI M.D.
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Gender | Male
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Dates
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Enumeration Date | 09/24/2006
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Last Update Date | 06/16/2025
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Provider Practice Location Address
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Address Line | BEHAVIORAL HEALTHCARE SERVICES 435 SHREWSBURY STREET
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City | WORCESTER
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State | MA
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Zip | 01604-1689
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Country | US
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Telephone | 508-753-5554
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Fax | 508-752-7245
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Provider Business Mailing Address
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Address Line | 435 SHREWSBURY STREET
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City | WORCESTER
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State | MA
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Zip | 01604-1689
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Country | US
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Telephone | 508-753-5554
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Fax | 508-752-7245
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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 | 2084A0401X
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Taxonomy Name | Addiction Medicine (Psychiatry & Neurology) Physician
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License Number | 59555
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 59555
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License Number State | MA
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