Organization
VITALIY MEDICAL AESTHETICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALICE WANGARI WAITHAKA FNP-BC,RN (FAMILY NURSE PRACTITIONER)
(857) 701-5425
Entity
Organization
Contact information
Practice address
10 DIXFIELD RD, WORCESTER, MA 01606-1084
(857) 701-5425
(508) 373-2429
Mailing address
10 DIXFIELD RD, WORCESTER, MA 01606-1084
(857) 701-5425
(508) 373-2429
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
08/23/2022
Last updated
08/23/2022
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