Healthcare Provider Details

I. General information

NPI: 1316948045
Provider Name (Legal Business Name): GARY GURKA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 08/03/2005
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

63 MASS AVE
ARLINGTON MA
02474-8612
US

IV. Provider business mailing address

43 HARRINGTON ST
WATERTOWN MA
02472-1015
US

V. Phone/Fax

Practice location:
  • Phone: 781-648-2540
  • Fax: 781-641-9844
Mailing address:
  • Phone: 781-648-2540
  • Fax: 781-641-9844

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number50276
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number5076
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: