Organization
STEPHEN M. DESIO, M.D., P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEPHEN M. DESIO M.D. (PRESIDENT)
(508) 363-6363
Entity
Organization
Contact information
Practice address
123 SUMMER ST, SUITE 520, WORCESTER, MA 01608-1216
(508) 363-6363
(508) 363-6366
Mailing address
23A CASTLE RD, NORTHBOROUGH, MA 01532-1248
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
80965
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9729411
—
MA
01
—
M21433
PTAN
MA
Enumeration date
07/27/2006
Last updated
02/12/2015
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