Healthcare Provider Details

I. General information

NPI: 1548132343
Provider Name (Legal Business Name): GIA KANG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/22/2025
Last Update Date: 11/08/2025
Certification Date: 11/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1985 MAIN ST
SPRINGFIELD MA
01103-1095
US

IV. Provider business mailing address

812 MEMORIAL DR APT 1802
CAMBRIDGE MA
02139-4928
US

V. Phone/Fax

Practice location:
  • Phone: 413-733-6639
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberRN2359044
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: