Individual
MARY TORKORNOO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
430 MASSASOIT RD, WORCESTER, MA 01604-3546
(508) 648-8533
Mailing address
430 MASSASOIT RD, WORCESTER, MA 01604-3546
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
RN233266
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
233266
—
MA
Enumeration date
01/31/2018
Last updated
06/26/2019
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