Individual
ALEXANDRA MATHASEN RIEDEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
76 VASSAR ST, WORCESTER, MA 01602-1535
(917) 604-2981
Mailing address
62 GOULD ST, WEST ROXBURY, MA 02132-5011
(617) 910-8252
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1922430818
NPI TYPE 1
—
Enumeration date
08/18/2025
Last updated
08/18/2025
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