Healthcare Provider Details

I. General information

NPI: 1235073297
Provider Name (Legal Business Name): ANGEL DANIEL GILES RN, EDD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/17/2026
Last Update Date: 04/17/2026
Certification Date: 04/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 COMMONWEALTH AVE # 526
BOSTON MA
02215-2606
US

IV. Provider business mailing address

29 FORDWAY ST
DERRY NH
03038-2633
US

V. Phone/Fax

Practice location:
  • Phone: 617-415-7660
  • Fax:
Mailing address:
  • Phone: 603-205-2238
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number116464-21
License Number StateNH
# 2
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN10032194
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: