JUSTIN J GWATIRISA

WORCESTER, MA
NPI1427209311
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363L00000X Nurse Practitioner
(Licence: MA  272730)
Enumeration Date2008-10-09
Last Update Date2008-10-09
Business Address
-- JUSTIN J GWATIRISA NP
55 LAKE AVE N DEPARTMENT OF SURGERY
WORCESTER, MA 01655-0002
Phone number: 508-856-5821
Mailing Address
-- JUSTIN J GWATIRISA NP
PO BOX 415348
BOSTON, MA 02241-5348
Phone number: