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NPI Code Detail

MEDICARE: DR. NICHOLAS GOPAL

MEDICARE: DR. NICHOLAS GOPAL
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacistPH239310MA

General Provider Information

NPI Number : 1003411000
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. NICHOLAS GOPAL
Provider Business Mailing Address
First Line : 220 TREMONT ST UNIT 2A
Second Line :
City : NEWTON
State : MA
Zip : 02458-2149
Country : US
Telephone Number : 860-538-1907
Fax Number :
Provider Business Practice Location Address
First Line : 195 CANAL ST
Second Line :
City : MALDEN
State : MA
Zip : 02148-6701
Country : US
Telephone Number : 617-665-2020
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/30/2020
Last Update Date : 03/27/2026

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Directions to “ DR. NICHOLAS GOPAL ” Practice Location

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