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Contact Information

ALICE A FANNIN, PA
630 PLANTATION ST
WORCESTER, MA01605
 Phone: 508-595-2000
 Fax: 508-853-7149
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physician Assistant

363A00000X 97 Physician Assistant
Indicates primary specialty

NPI Profile & details for ALICE A FANNIN · (Female)

NPI Number 1649240896
Status Active
Credentials PA (Physician Assistant)
Entity Individual
Enumeration date 01/23/2006
Last updated 07/08/2007 - About 19 years ago
Sole proprietor 1 Not specified
Identifiers
  • MA License # 1422
  • Other 8301088 EVERCARE
  • Other 53324 FALLON COMMUNITY HLTH PLN
  • Other AP1638 MEDICARE B
  • Other 970024208 RAILROAD MEDICARE
  • Other 042472266 THREE RIVERS
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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