Healthcare Provider Details

I. General information

NPI: 1578377487
Provider Name (Legal Business Name): ALFREDO OCHOA CRUZ
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/03/2025
Last Update Date: 09/11/2025
Certification Date: 09/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 WASHINGTON AVE
CHELSEA MA
02150-3902
US

IV. Provider business mailing address

2 WASHINGTON AVE
CHELSEA MA
02150-3902
US

V. Phone/Fax

Practice location:
  • Phone: 617-887-2100
  • Fax:
Mailing address:
  • Phone: 617-887-2100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDN10001085
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: