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General NPI Number Information
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NPI Number | 1659831139
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Entity Type | Individual
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Provider Name | GABRIEL SIMON CHAIN MD
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Gender | Male
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Dates
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Enumeration Date | 03/21/2019
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Last Update Date | 07/25/2025
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Provider Practice Location Address
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Address Line | 55 FRUIT ST
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City | BOSTON
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State | MA
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Zip | 02114-2696
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Country | US
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Telephone | 617-726-2000
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Fax |
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Provider Business Mailing Address
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Address Line | 7 WYATT ST
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City | SOMERVILLE
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State | MA
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Zip | 02143-3917
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Country | US
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Telephone | 718-650-0302
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 25MA11471000
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 1022192
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License Number State | MA
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Taxonomy #3
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Taxonomy Code | 2080H0002X
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Taxonomy Name | Pediatric Hospice and Palliative Medicine Physician
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License Number | 1022192
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License Number State | MA
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Taxonomy #4
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Taxonomy Code | 2080H0002X
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Taxonomy Name | Pediatric Hospice and Palliative Medicine Physician
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License Number | C1-0026873
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License Number State | DE
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Taxonomy #5
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 25MA11471000
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License Number State | NJ
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