Individual
STEPHANIE P. CARREIRO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
55 LAKE AVE N, WORCESTER, MA 01655-0002
(508) 421-1400
(508) 421-1490
Mailing address
PO BOX 415348, BOSTON, MA 02241-5348
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
254430
MA
207PT0002X
Medical Toxicology (Emergency Medicine) Physician
254430
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110095519A
—
MA
Enumeration date
06/26/2009
Last updated
11/10/2020
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