Individual
KEVIN ROBERT DORAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
AG-ACNP
Contact information
Practice address
55 LAKE AVE N, WORCESTER, MA 01655-0002
(508) 334-3155
Mailing address
PO BOX 415348, BOSTON, MA 02241-5348
(800) 225-8885
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN276827
MA
363LC0200X
Critical Care Medicine Nurse Practitioner
RN276827
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110104593A
—
MA
Enumeration date
08/14/2014
Last updated
09/06/2024
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