Provider Demographics
NPI:1093210718
Name:GELLMAN, YECHIEL NISAN (MD, MSC)
Entity Type:Individual
Prefix:DR
First Name:YECHIEL
Middle Name:NISAN
Last Name:GELLMAN
Suffix:
Gender:M
Credentials:MD, MSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1731 BEACON ST APT 4
Mailing Address - Street 2:
Mailing Address - City:BROOKLINE
Mailing Address - State:MA
Mailing Address - Zip Code:02445-5322
Mailing Address - Country:US
Mailing Address - Phone:857-753-8722
Mailing Address - Fax:
Practice Address - Street 1:NEW ENGLAND BAPTIST HOSPITAL
Practice Address - Street 2:125 PARKER HILL AVENUE
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02120-2847
Practice Address - Country:US
Practice Address - Phone:857-753-8722
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-26
Last Update Date:2018-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA270574207XX0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0004XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryFoot and Ankle Surgery