Provider Demographics
NPI:1245007442
Name:KORKORLOR, YASSAH DORCAS
Entity type:Individual
Prefix:
First Name:YASSAH
Middle Name:DORCAS
Last Name:KORKORLOR
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 1:101 HARRISON ST APT 3
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01604-6140
Mailing Address - Country:US
Mailing Address - Phone:774-253-1020
Mailing Address - Fax:
Practice Address - Street 1:101 HARRISON ST APT 3
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01604-6140
Practice Address - Country:US
Practice Address - Phone:774-253-1020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-07
Last Update Date:2023-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide