Gonzalez, Shirley
Gonzalez, Shirley is an individual health care provider with primary practice located at 40 Spring St , Watertown MA 02472-3444. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Gonzalez, Shirley can be contacted via phone (617) 926-0114.Contact Information
Primary practice address
40 Spring St
Watertown MA 02472-3444
Phone: (617) 926-0114
Fax: (617) 926-7052
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 153812 | Massachusetts |
Profile Details
| NPI number | 1366438616 |
|---|---|
| LBN Legal business name | Gonzalez, Shirley |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 22nd, 2005 |
| Last updated | Dec 17th, 2013 - about 11 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1366438616 | NPPES |
| Massachusetts | MEDICAID | 3201180 |
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