Individual
MIRA ROSTOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DR
Contact information
Practice address
500 GRAFTON ST STE 2, WORCESTER, MA 01604-4799
(978) 840-8343
Mailing address
500 GRAFTON ST, WORCESTER, MA 01604-4713
(508) 798-8743
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PH239106
MA
Other
Enumeration date
11/30/2020
Last updated
11/08/2025
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