1043469505 NPI number — DORY TOSI LICSW

Table of content: DORY TOSI LICSW (NPI 1043469505)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1043469505 NPI number — DORY TOSI LICSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
TOSI
Provider First Name:
DORY
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
LICSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1043469505
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/07/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
34 CAMELOT DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WORCESTER
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
01602-1353
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
978-921-4000
Provider Business Mailing Address Fax Number:
978-921-7530

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
900 CUMMINGS CTR
Provider Second Line Business Practice Location Address:
STE 405T
Provider Business Practice Location Address City Name:
BEVERLY
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
01915-6184
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
978-985-0693
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/09/2008

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)