1235110941 NPI number — CAROLINE TOOMEY-GITTO O.D.

Table of content: CAROLINE TOOMEY-GITTO O.D. (NPI 1235110941)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1235110941 NPI number — CAROLINE TOOMEY-GITTO O.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
TOOMEY-GITTO
Provider First Name:
CAROLINE
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
O.D.
Provider Gender Code:
F

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:
1235110941
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/05/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
940 COMMONWEALTH AVENUE
Provider Second Line Business Mailing Address:
SUITE 2
Provider Business Mailing Address City Name:
BOSTON
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02215
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
617-587-5511
Provider Business Mailing Address Fax Number:
617-587-5514

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
799 WEST BOYLSTON STREET
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:
01606
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
617-587-5511
Provider Business Practice Location Address Fax Number:
617-587-5514
Provider Enumeration Date:
11/09/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 152W00000X , with the licence number:  3377 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 0353876 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2855138 . This is a "CIGNA" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 4667155 . This is a "AETNA" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: MA3377 . This is a "EYEMED" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 150557 . This is a "HARVARD PILGRIM" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 042621019 . This is a "CORP TAX ID" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0353876 . This is a "MASS HEALTH" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com