1174559363 NPI number — FRANCISCOS. GIL M.D., PC

Table of content: (NPI 1174559363)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1174559363 NPI number — FRANCISCOS. GIL M.D., PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
FRANCISCOS. GIL M.D., PC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1174559363
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/08/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
10 WINTHROP ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WORCESTER
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
01604
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
508-799-2922
Provider Business Mailing Address Fax Number:
508-755-4075

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10 WINTHROP ST.
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WORCESTER
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
01604
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
508-799-2922
Provider Business Practice Location Address Fax Number:
508-755-4075
Provider Enumeration Date:
06/23/2006

Additional Information

Authorized Official

Authorized Official Last Name:
VALENTIN
Authorized Official First Name:
EVELIZ
Authorized Official Middle Name:
Authorized Official Title or Position:
OFFICE MANAGER
Authorized Official Telephone Number:
508-799-2922

Provider Taxonomy Codes

  • Taxonomy code: 261QP2300X , with the licence number:  40011 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 261QP2300X , with the licence number: 216617 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 110068558A , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".




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