MEDICARE: PETER C GHERARDI M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician	74001	MA

General Provider Information

NPI Number	:	1699722843
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PETER C GHERARDI M.D.

Provider Business Mailing Address
First Line	:	16 EMERSON ST
Second Line	:
City	:	BROOKLINE
State	:	MA
Zip	:	02445-6846
Country	:	US
Telephone Number	:	978-322-5160
Fax Number	:

Provider Business Practice Location Address
First Line	:	1 WASHINGTON ST
Second Line	:	COMMUNITY COUNSELING OF BRISTOL COUNTY
City	:	TAUNTON
State	:	MA
Zip	:	02780-3960
Country	:	US
Telephone Number	:	508-828-9116
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/30/2006
Last Update Date	:	07/26/2012

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