Kane-Wanger, Gwendolyn

Kane-Wanger, Gwendolyn is an individual health care provider with primary practice located at 125 Parker Hill Ave , Roxbury Crossing MA 02120-2847. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Rheumatology, Allopathic & Osteopathic Physicians / Internal Medicine. Allopathic & Osteopathic Physicians / Rheumatology is her primary health care specialty. Kane-Wanger, Gwendolyn can be contacted via phone (617) 754-5800.

Contact Information

Primary practice address
125 Parker Hill Ave Roxbury Crossing MA 02120-2847
Phone: (617) 754-5800
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Rheumatology 207RR0500X 75535 Massachusetts
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 75535 Massachusetts

Profile Details

NPI number 1801876735
LBN Legal business name Kane-Wanger, Gwendolyn
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 18th, 2006
Last updated Oct 30th, 2019 - 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 1801876735 NPPES
Massachusetts MEDICAID 3143686

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