Provider Demographics
NPI:1275265969
Name:OBORSKI, ALEJANDRA (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:ALEJANDRA
Middle Name:
Last Name:OBORSKI
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:MONICA
Other - Middle Name:ALEJANDRA
Other - Last Name:OBORSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:95 BRITT RD
Mailing Address - Street 2:
Mailing Address - City:EAST HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06118-3348
Mailing Address - Country:US
Mailing Address - Phone:860-798-3097
Mailing Address - Fax:
Practice Address - Street 1:617 WATERTOWN AVE
Practice Address - Street 2:
Practice Address - City:WATERBURY
Practice Address - State:CT
Practice Address - Zip Code:06708-2243
Practice Address - Country:US
Practice Address - Phone:203-753-2119
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-30
Last Update Date:2022-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT5730363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant