Individual
MR. MOHANDAS DIVI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
503 MILL STREET, APT #335, WORCESTER, MA 01602
(508) 753-0929
Mailing address
503 MILL STREET, APT #335, WORCESTER, MA 01602
(508) 425-3179
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
258470
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0710946
INDEPENDENT NURSEPROVIDER
MA
Enumeration date
05/01/2007
Last updated
01/04/2011
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