Provider Demographics
NPI:1205324746
Name:KAHORO, JOSEPH WANJA
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:WANJA
Last Name:KAHORO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:123 HOUGHTON ST
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01604-3936
Mailing Address - Country:US
Mailing Address - Phone:508-792-5314
Mailing Address - Fax:
Practice Address - Street 1:118 W MAIN ST
Practice Address - Street 2:
Practice Address - City:SPENCER
Practice Address - State:MA
Practice Address - Zip Code:01562-2621
Practice Address - Country:US
Practice Address - Phone:508-885-3025
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-30
Last Update Date:2018-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical