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CHRISTOPHER MIRARA CHEONGA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
RN

Contact information

Practice address
19 TACOMA ST, WORCESTER, MA 01605-3516
(508) 852-1805
(508) 854-3248
Mailing address
19 TACOMA ST, WORCESTER, MA 01605-3516
(508) 852-1805
(508) 854-3248

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN2268032
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1301071
GROUP MEDICAID NUMBER
MA
Enumeration date
03/10/2011
Last updated
03/10/2011
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