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General NPI Number Information
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NPI Number | 1528045812
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Entity Type | Organization
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Legal Business Name | EUGENE C. JAGELLA, M.D. PC
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Dates
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Enumeration Date | 12/28/2005
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Last Update Date | 11/17/2009
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Provider Practice Location Address
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Address Line | 40 PROSPECT ST
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City | MILFORD
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State | MA
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Zip | 01757-3026
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Country | US
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Telephone | 508-478-4618
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 9132
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City | BROOKLINE
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State | MA
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Zip | 02446-9132
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Country | US
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Telephone | 603-893-9784
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Fax | 603-893-8886
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. EUGENE C JAGELLA
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Credential | M.D.
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Telephone | 508-478-4618
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State | MA
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