Individual
DOROTHY KAYE DECUBELLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
123 SUMMER ST, WORCESTER, MA 01608-1216
(508) 363-7449
(508) 363-7512
Mailing address
47 CENTRAL ST, SOUTHBOROUGH, MA 01745-1003
(617) 671-8052
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN2274954
MA
363LF0000X
Family Nurse Practitioner
RN2274954
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110170519A
—
MA
Enumeration date
11/30/2020
Last updated
02/03/2023
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