Provider Demographics
NPI:1770665952
Name:NOBIS, JOYEE
Entity Type:Individual
Prefix:
First Name:JOYEE
Middle Name:
Last Name:NOBIS
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 1:45 OAK AVE
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01605-2730
Mailing Address - Country:US
Mailing Address - Phone:508-756-2020
Mailing Address - Fax:508-756-0705
Practice Address - Street 1:45 OAK AVE
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01605-2730
Practice Address - Country:US
Practice Address - Phone:508-756-2020
Practice Address - Fax:508-756-0705
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-19
Last Update Date:2011-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA387322080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA6168345Medicaid
MAD88239Medicare UPIN