1689886988 NPI number — GAY MICHAELES RN,MS,CS.

Table of content: GAY MICHAELES RN,MS,CS. (NPI 1689886988)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1689886988 NPI number — GAY MICHAELES RN,MS,CS.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MICHAELES
Provider First Name:
GAY
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
RN,MS,CS.
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:
1689886988
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
10 CHURCH ST
Provider Second Line Business Mailing Address:
SUITE3
Provider Business Mailing Address City Name:
NORTHBOROUGH
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
01532-3805
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
150-839-3575
Provider Business Mailing Address Fax Number:
150-839-3611

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10 CHURCH ST
Provider Second Line Business Practice Location Address:
SUITE3
Provider Business Practice Location Address City Name:
NORTHBOROUGH
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
01532-3805
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
150-839-3575
Provider Business Practice Location Address Fax Number:
150-839-3611
Provider Enumeration Date:
05/07/2007

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: 163WP0808X , with the licence number:  1577744 , 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)





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