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NPI Code Detail

MEDICARE: BRONIE GORELIK MD

MEDICARE:   BRONIE  GORELIK  MD
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
1208000000XPediatrics Physician150605MA

General Provider Information

NPI Number : 1194712422
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRONIE GORELIK MD
Provider Business Mailing Address
First Line : 77 WARREN ST
Second Line : RM 339
City : BRIGHTON
State : MA
Zip : 02135
Country : US
Telephone Number : 617-562-5359
Fax Number : 617-562-5415
Provider Business Practice Location Address
First Line : 380R MERRIMACK ST
Second Line :
City : METHUEN
State : MA
Zip : 01844-5883
Country : US
Telephone Number : 978-687-6355
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/03/2005
Last Update Date : 11/27/2013

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Directions to “ BRONIE GORELIK MD” Practice Location

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