Healthcare Provider Details

I. General information

NPI: 1154548683
Provider Name (Legal Business Name): WILLIAM T GONSALVES
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/19/2007
Last Update Date: 06/30/2025
Certification Date: 06/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

595 HANOVER ST
FALL RIVER MA
02720-3721
US

IV. Provider business mailing address

363 HIGHLAND AVE CLINICAL ENGINEERING DEPARTMENT
FALL RIVER MA
02720-3703
US

V. Phone/Fax

Practice location:
  • Phone: 508-677-7195
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246ZB0301X
TaxonomyBiomedical Engineer
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225500000X
TaxonomyRespiratory/Developmental/Rehabilitative Specialist/Technologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: