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Individual

DR. MARY M STAFFA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
5 NEPONSET ST, WORCESTER, MA 01606-2714
(508) 853-2716
(508) 854-0479
Mailing address
5 NEPONSET ST FL STREET12, WORCESTER, MA 01606-2714
(508) 853-2716
(508) 854-0479

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
70412
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3076351
MA
01
732821
TUFTS HEALTH PLAN
MA
01
J10760
BCBS MA
MA
Enumeration date
11/14/2005
Last updated
09/14/2018
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