Individual
MOHAMAD TANTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
19 FOSTER ST, WORCESTER, MA 01608-1715
(508) 890-8855
Mailing address
19 FOSTER ST, WORCESTER, MA 01608-1715
(508) 890-8855
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA100624
MA
Other
Enumeration date
02/01/2023
Last updated
01/09/2026
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