Provider Demographics
NPI:1164083499
Name:MILLA GODOY, GABRIELA CRISTINA (MD)
Entity Type:Individual
Prefix:
First Name:GABRIELA
Middle Name:CRISTINA
Last Name:MILLA GODOY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 FRANCIS ST # STREETA4
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02115-6105
Mailing Address - Country:US
Mailing Address - Phone:617-732-8881
Mailing Address - Fax:617-732-6829
Practice Address - Street 1:15 FRANCIS ST # STREETA4
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115-6105
Practice Address - Country:US
Practice Address - Phone:617-732-8881
Practice Address - Fax:617-732-6829
Is Sole Proprietor?:No
Enumeration Date:2019-06-26
Last Update Date:2023-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA281098207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine