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1427209311
JUSTIN J GWATIRISA
WORCESTER, MA
NPI
1427209311
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363L00000X Nurse Practitioner
(Licence: MA 272730)
Enumeration Date
2008-10-09
Last Update Date
2008-10-09
Business Address
-- JUSTIN J GWATIRISA NP
55 LAKE AVE N DEPARTMENT OF SURGERY
WORCESTER, MA 01655-0002
Phone number: 508-856-5821
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Mailing Address
-- JUSTIN J GWATIRISA NP
PO BOX 415348
BOSTON, MA 02241-5348
Phone number:
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