Individual
IDAH M. SHAYO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
630 PLANTATION ST, WOT 12TH FL, WORCESTER, MA 01605-2038
(508) 595-2300
(508) 853-5226
Mailing address
630 PLANTATION ST, WOT 12TH FL, WORCESTER, MA 01605-2038
(508) 368-5424
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN278932
MA
Other
Enumeration date
11/01/2011
Last updated
11/01/2011
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