Basic Information
| Provider Information | |||||||||
| NPI: | 1952530685 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MADARIYA | ||||||||
| FirstName: | ANA | ||||||||
| MiddleName: | SUJATA | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5 NEPONSET ST FL STREET2 | ||||||||
| Address2: | |||||||||
| City: | WORCESTER | ||||||||
| State: | MA | ||||||||
| PostalCode: | 016062714 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5089496874 | ||||||||
| FaxNumber: | 5089496739 | ||||||||
| Practice Location | |||||||||
| Address1: | 123 SUMMER ST STE 150S | ||||||||
| Address2: | |||||||||
| City: | WORCESTER | ||||||||
| State: | MA | ||||||||
| PostalCode: | 016081216 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5083683110 | ||||||||
| FaxNumber: | 5083683113 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/02/2009 | ||||||||
| LastUpdateDate: | 03/13/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | 60344560 | WA | N | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | 390200000X | 62860 | NY | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207V00000X | 269093 | MA | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
No ID Information.