Healthcare Provider Details

I. General information

NPI: 1134900459
Provider Name (Legal Business Name): MARLENE GIL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/12/2023
Last Update Date: 10/12/2023
Certification Date: 10/12/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

99 S MAIN ST STE 10
FALL RIVER MA
02721-5349
US

IV. Provider business mailing address

535 8TH AVE FL 9
NEW YORK NY
10018-2486
US

V. Phone/Fax

Practice location:
  • Phone: 800-579-3609
  • Fax:
Mailing address:
  • Phone: 800-679-3609
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: