Individual
GENER ALEJANDRO FAJARDO RUIZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
SA-C
Contact information
Practice address
23 COUNTY ST, WORCESTER, MA 01604-2403
(774) 253-2716
Mailing address
23 COUNTY ST, WORCESTER, MA 01604-2403
(774) 253-2716
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
19-500
MA
Other
Enumeration date
01/13/2020
Last updated
01/13/2020
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