Individual
MIREYA A WESSOLOSSKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
55 LAKE AVE N, WORCESTER, MA 01655-0002
(774) 441-8230
Mailing address
PO BOX 415348, BOSTON, MA 02241-5348
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
153768
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110038627A
—
MA
Enumeration date
10/26/2005
Last updated
02/05/2026
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