Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LC0200X | Nurse Practitioner - Critical Care Medicine | RN276827 | MA |
NPI | 1447659636 |
---|---|
Provider Name | Kevin Robert Doray |
First Address | Auburn, MA 01501-1725 |
Second Address | Worcester, MA 01608-1216 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/08/2014 |
Last Update Date | 29/01/2020 |