Healthcare Provider Details

I. General information

NPI: 1114993466
Provider Name (Legal Business Name): GAIL M MARTELL RN
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 02/27/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 LONGWOOD AVE FLOOR 3
BOSTON MA
02115-5711
US

IV. Provider business mailing address

185 OAK ST
MARSHFIELD MA
02050-6249
US

V. Phone/Fax

Practice location:
  • Phone: 617-355-8866
  • Fax: 617-730-0320
Mailing address:
  • Phone: 781-834-7721
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WX0601X
TaxonomyOtorhinolaryngology & Head-Neck Registered Nurse
License Number151993
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: