Individual
ALEXANDR TARASYUK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
123 SUMMER ST, WORCESTER, MA 01608-1216
(508) 363-6363
(508) 363-7164
Mailing address
123 SUMMER STREET, WORCESTER, MA 01608
(508) 363-6363
(508) 363-7164
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2785
CT
363AS0400X
Surgical Physician Assistant
PA4219
MA
Other
Enumeration date
08/10/2011
Last updated
09/10/2019
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