Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223G0001X | General Practice | 14950 | MA |
Y | 213EG0000X | General Practice | 14950 | MA |
NPI | 1003929290 |
---|---|
Provider Name | Ernest Algis Gailiunas |
First Address | Cotuit, MA 02635 |
Second Address | Cotuit, MA 02635 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/08/2006 |
Last Update Date | 07/05/2014 |