Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207PP0204X | Pediatric Emergency Physician | 287153 | MA |
Y | 208000000X | Pediatrician | MT212922 | PA |
NPI | 1720517758 |
---|---|
Provider Name | Laurel Sydney Gabler |
First Address | Boston, MA 02115-5724 |
Second Address | Boston, MA 02115-5724 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/06/2017 |
Last Update Date | 21/07/2021 |