Provider Demographics
NPI:1144388091
Name:WINTERSTEINER, GAIL S
Entity Type:Individual
Prefix:DR
First Name:GAIL
Middle Name:S
Last Name:WINTERSTEINER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 IRVINGTON ST
Mailing Address - Street 2:
Mailing Address - City:WABAN
Mailing Address - State:MA
Mailing Address - Zip Code:02468-1906
Mailing Address - Country:US
Mailing Address - Phone:617-965-1038
Mailing Address - Fax:
Practice Address - Street 1:22 IRVINGTON ST
Practice Address - Street 2:
Practice Address - City:WABAN
Practice Address - State:MA
Practice Address - Zip Code:02468-1906
Practice Address - Country:US
Practice Address - Phone:617-965-1038
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2434103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAW02589Medicare ID - Type UnspecifiedPSYCHOLOGIST