Provider Demographics
NPI:1609754704
Name:DORER, JOSEPH ANDREW-DONALD
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:ANDREW-DONALD
Last Name:DORER
Suffix:
Gender:X
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:771 HARRISON AVE UNIT PH6
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02118-3587
Mailing Address - Country:US
Mailing Address - Phone:202-957-5287
Mailing Address - Fax:
Practice Address - Street 1:85 E NEWTON ST # M912
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02118-3553
Practice Address - Country:US
Practice Address - Phone:202-957-5287
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-26
Last Update Date:2025-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program