Most Relevant Information
Provider Data
| NPI Number: | 1003445164 |
| Provider Name: | JASON DI YANG |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: |
Most Important Dates
| Enumeration Date: | 04/02/2020 |
| Last Updated: | 04/23/2020 |
Provider Practice Location
55 LAKE AVE N
WORCESTER
MA
016550002
Practice Location Phone/Fax
| Phone: | 7744422173 |
| Fax: | 7744426781 |
Provider Mailing Location
55 LAKE AVE N
WORCESTER
MA
016550002
Provider Mailing Phone/Fax
| Phone: | 7744422173 |
| Fax: | 7744426781 |