Gale, Evan Dov

Gale, Evan Dov is an sole proprietor health care provider with primary practice located at 55 Fruit St Founders 8, Boston MA 02114-2621. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Addiction Medicine. Allopathic & Osteopathic Physicians / Addiction Medicine is his primary health care specialty. Gale, Evan Dov can be contacted via phone (617) 643-8280.

Contact Information

Primary practice address
55 Fruit St Founders 8 Boston MA 02114-2621
Phone: (617) 643-8280
Fax: (617) 643-0683
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 62519 Connecticut
Allopathic & Osteopathic Physicians / Addiction Medicine 207RA0401X 62519 Connecticut
Allopathic & Osteopathic Physicians / Addiction Medicine 207RA0401X 283531 Massachusetts

Profile Details

NPI number 1306294764
LBN Legal business name Gale, Evan Dov
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 26th, 2016
Last updated Jun 25th, 2020 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1306294764 NPPES
Connecticut MEDICAID 004217099
Connecticut MEDICAID 008087608

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