Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 233958 | MA |
Y | 208600000X | Surgeon | 233958 | MA |
N | 2086X0206X | Surgical Oncologist | 233958 | MA |
NPI | 1265590434 |
---|---|
Provider Name | Dr. Jason Samuel Gold |
First Address | West Roxbury, MA 02132-4927 |
Second Address | West Roxbury, MA 02132-4927 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/12/2006 |
Last Update Date | 28/09/2007 |