MEDICARE: GABRIEL BELOSEVIC NP, RN, AGPCNP-BC

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	207RG0300X	Geriatric Medicine (Internal Medicine) Physician	RN227279	MA
2	163W00000X	Registered Nurse	RN2277279	MA
3	363LA2200X	Adult Health Nurse Practitioner	RN2277279	MA
4	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	RN2277279	MA
5	363LG0600X	Gerontology Nurse Practitioner	RN2277279	MA

General Provider Information

NPI Number	:	1972861607
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GABRIEL BELOSEVIC NP, RN, AGPCNP-BC

Provider Business Mailing Address
First Line	:	1340 BOYLSTON ST
Second Line	:
City	:	BOSTON
State	:	MA
Zip	:	02215-4302
Country	:	US
Telephone Number	:	617-927-6099
Fax Number	:

Provider Business Practice Location Address
First Line	:	254 2ND AVE
Second Line	:
City	:	NEEDHAM HEIGHTS
State	:	MA
Zip	:	02494-2829
Country	:	US
Telephone Number	:	617-421-2686
Fax Number	:

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

Provider Enumeration Date	:	05/01/2012
Last Update Date	:	12/28/2023

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