Saucedo, Jason Edward Derek
Saucedo, Jason Edward Derek is an individual health care provider with primary practice located at 55 Lake Ave N , Worcester MA 01655. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Nuclear Cardiology, Allopathic & Osteopathic Physicians / Cardiovascular Disease. Allopathic & Osteopathic Physicians / Cardiovascular Disease is his primary health care specialty. Saucedo, Jason Edward Derek can be contacted via phone (508) 334-3452.Contact Information
Primary practice address
55 Lake Ave N
Worcester MA 01655
Phone: (508) 334-3452
Fax: (774) 441-7657
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 269496 | Massachusetts |
| Allopathic & Osteopathic Physicians / Nuclear Cardiology | 207UN0901X | 269496 | Massachusetts |
| Allopathic & Osteopathic Physicians / Cardiovascular Disease | 207RC0000X | 269496 | Massachusetts |
Profile Details
| NPI number | 1528270253 |
|---|---|
| LBN Legal business name | Saucedo, Jason Edward Derek |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 4th, 2007 |
| Last updated | Dec 8th, 2023 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1528270253 | NPPES |
| Massachusetts | MEDICAID | 110121488A |
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