Clarence D Gonsalves

NPI 1144496878 - Case Manager/Care Coordinator - 171M00000X

NPI Details
NPI 1144496878
Gender Male
Enumeration Date 05/02/2008
Last Updated 05/23/2011
Entity Type Individual
Active Over 8 years ago
Practice Location
321 BLUE HILL AVE
BOSTON MA, 02121-4302, US
Phone (617) 541-6859
Fax
Business Location
84 MOUNT VERNON ST # 2
MALDEN MA, 02148-6714, US
Phone (857) 247-7425
Fax
Toxanomy
Taxonomy Code 171M00000X
License State Massachusetts
License Number S71703937
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According to our database, Clarence D Gonsalves NPI is 1144496878, taxonomy code is 171M00000X and license number is S71703937, license state is located at Massachusetts. Clarence D Gonsalves physically located at 321 Blue Hill Ave, Boston MA, 02121-4302. NPI Number Clarence D Gonsalves has the Individual type.

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1144496878 NPI number is provided on an as is basis without warranty of any kind. 1144496878 is maintained by the National Plan & Provider Enumeration System. The contents of Clarence D Gonsalves are for informational purposes only.