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NPI Code Detail

MEDICARE: PATRICE MAUREEN MUCHOWSKI SC.D.

MEDICARE: PATRICE MAUREEN MUCHOWSKI SC.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103T00000XPsychologistMA2885MA

General Provider Information

NPI Number : 1114062544
Entity Type Code : Individual
Provider Name (Legal Business Name) : PATRICE MAUREEN MUCHOWSKI SC.D.
Provider Business Mailing Address
First Line : 107 LINCOLN ST
Second Line :
City : WORCESTER
State : MA
Zip : 01605-2401
Country : US
Telephone Number : 508-453-3039
Fax Number : 508-753-3733
Provider Business Practice Location Address
First Line : 107 LINCOLN ST
Second Line :
City : WORCESTER
State : MA
Zip : 01605-2401
Country : US
Telephone Number : 508-453-3039
Fax Number : 508-753-3733
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/21/2007
Last Update Date : 07/08/2007

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Directions to “ PATRICE MAUREEN MUCHOWSKI SC.D.” Practice Location

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