MEDICARE: DR. GARY TREY M.D.

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
1	207RG0100X	Gastroenterology Physician	57207	MA

General Provider Information

NPI Number	:	1508853417
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GARY TREY M.D.

Provider Business Mailing Address
First Line	:	45 LONGWOOD AVE
Second Line	:	APARTMENT A
City	:	BROOKLINE
State	:	MA
Zip	:	02446-5244
Country	:	US
Telephone Number	:	617-731-2676
Fax Number	:

Provider Business Practice Location Address
First Line	:	1180 BEACON ST STE 6B
Second Line	:
City	:	BROOKLINE
State	:	MA
Zip	:	02446-3806
Country	:	US
Telephone Number	:	817-770-4064
Fax Number	:	781-682-6157

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/05/2005
Last Update Date	:	09/15/2021

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