Provider Demographics
NPI:1174139281
Name:SAFO, JOY ANNE (NP)
Entity type:Individual
Prefix:
First Name:JOY
Middle Name:ANNE
Last Name:SAFO
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:AKOSUA
Other - Middle Name:AWISI
Other - Last Name:SAFO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5 NEPONSET ST FL CENTER12
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01606-2714
Mailing Address - Country:US
Mailing Address - Phone:085-460-3190
Mailing Address - Fax:508-460-3279
Practice Address - Street 1:24 NEWTON ST
Practice Address - Street 2:
Practice Address - City:SOUTHBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:01772-1215
Practice Address - Country:US
Practice Address - Phone:508-460-3190
Practice Address - Fax:508-460-3279
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-23
Last Update Date:2025-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN248379363LP0808X
MARN10014945363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MARN10014945OtherADVANCE PRACTICE-NP