Individual
NISHA MEGAN FAHEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
55 LAKE AVE N, WORCESTER, MA 01655-0002
(774) 442-2853
(774) 443-7268
Mailing address
PO BOX 415348, BOSTON, MA 02241-5348
(800) 225-8885
(508) 334-1977
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
279034
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110118202A
—
MA
Enumeration date
03/28/2016
Last updated
04/10/2024
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