Ida P Gorenburg M.D.

NPI 1053386771 - Internal Medicine - 207R00000X

NPI Details
NPI 1053386771
Gender Female
Enumeration Date 02/17/2006
Last Updated 06/27/2011
Entity Type Individual
Active Over 10 years ago
Practice Location
230 WORCESTER ST
INTERNAL MEDICINE
WELLESLEY MA, 02481-5420, US
Phone (781) 431-5444
Fax (781) 431-5443
Business Location
147 MILK ST
PROVIDER ENROLLMENT - 9TH FLOOR
BOSTON MA, 02109-4806, US
Phone (617) 559-8374
Fax
Toxanomy
Taxonomy Code 207R00000X
License State Massachusetts
License Number 220258
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According to our database, Ida P Gorenburg M.D. NPI is 1053386771, taxonomy code is 207R00000X and license number is 220258, license state is located at Massachusetts. Ida P Gorenburg M.D. physically located at 230 Worcester St, Wellesley MA, 02481-5420. NPI Number Ida P Gorenburg M.D. has the Individual type.

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1053386771 NPI number is provided on an as is basis without warranty of any kind. 1053386771 is maintained by the National Plan & Provider Enumeration System. The contents of Ida P Gorenburg M.D. are for informational purposes only.