Individual
VIJAYA THOMAS DANIEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
281 LINCOLN ST, WORCESTER, MA 01605-2138
(508) 334-5979
Mailing address
PO BOX 415348, BOSTON, MA 02241-5348
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
275578
MA
Other
Enumeration date
04/07/2014
Last updated
09/07/2024
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