Individual
LISETTA D. SHAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
5 NEPONSET STREET, WORCESTER, MA 01606-2714
Mailing address
5 NEPONSET ST FL CENTER12, WORCESTER, MA 01606-2714
(088) 520-6005
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
273416
MA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/31/2015
Last updated
06/24/2025
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