Provider Demographics
NPI:1235347808
Name:SHROFF, KRISHNA V
Entity Type:Individual
Prefix:MRS
First Name:KRISHNA
Middle Name:V
Last Name:SHROFF
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 MAIN ST
Mailing Address - Street 2:APT # 702
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01608-2061
Mailing Address - Country:US
Mailing Address - Phone:508-753-9022
Mailing Address - Fax:
Practice Address - Street 1:55 LAKE AVE NORTH
Practice Address - Street 2:UNIVERSITY OF MASSACHUSETTS MEMORIAL MEDICAL CENTER
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01655
Practice Address - Country:US
Practice Address - Phone:508-856-4942
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA26970183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist