Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | 222866 | MA |
N | 208D00000X | General Practice Physician | 61304 | CT |
NPI | 1023088820 |
---|---|
Provider Name | Flora F Sadri-Azarbayejani |
First Address | Turners Falls, MA 01376-1830 |
Second Address | Worcester, MA 01603-1548 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/01/2006 |
Last Update Date | 11/02/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1301128 | (05) | MA |
I12588 | (02) |