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General NPI Number Information
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NPI Number | 1093210718
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Entity Type | Individual
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Provider Name | YECHIEL NISAN GELLMAN MD, MSC
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Gender | Male
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Dates
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Enumeration Date | 03/26/2018
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Last Update Date | 03/28/2018
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Provider Practice Location Address
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Address Line | NEW ENGLAND BAPTIST HOSPITAL 125 PARKER HILL AVENUE
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City | BOSTON
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State | MA
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Zip | 02120-2847
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Country | US
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Telephone | 857-753-8722
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Fax |
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Provider Business Mailing Address
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Address Line | 1731 BEACON ST APT 4
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City | BROOKLINE
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State | MA
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Zip | 02445-5322
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Country | US
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Telephone | 857-753-8722
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207XX0004X
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Taxonomy Name | Orthopaedic Foot and Ankle Surgery Physician
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License Number | 270574
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License Number State | MA
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