Gibbons, Gary W

Gibbons, Gary W is an individual health care provider with primary practice located at 732 Harrison Ave Preston 2, Boston MA 02118-2656. He recently has only one registered license in Allopathic & Osteopathic Physicians / Vascular Surgery, which is considered as his primary health care specialty. Gibbons, Gary W can be contacted via phone (617) 414-6840.

Contact Information

Primary practice address
732 Harrison Ave Preston 2 Boston MA 02118-2656
Phone: (617) 414-6840
Fax: (617) 414-6710
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Vascular Surgery 2086S0129X 34791 Massachusetts

Profile Details

NPI number 1558322040
LBN Legal business name Gibbons, Gary W
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 1st, 2006
Last updated Mar 14th, 2017 - about 8 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 1558322040 NPPES
Massachusetts MEDICAID 2016621

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