Individual
MARY-ALICE ABBOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
55 LAKE AVE N, WORCESTER, MA 01655-0002
(774) 442-5695
(774) 442-3525
Mailing address
PO BOX 415348, BOSTON, MA 02241-5348
(800) 225-8885
(508) 334-1977
Taxonomy
Speciality
Code
Description
License number
State
207SG0201X
Clinical Genetics (M.D.) Physician
Primary
223601
MA
208000000X
Pediatrics Physician
223601
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110041048A
—
MA
Enumeration date
10/03/2006
Last updated
02/05/2025
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