Provider Demographics
NPI:1245215805
Name:TORKILDSEN, GAIL L (MD)
Entity Type:Individual
Prefix:DR
First Name:GAIL
Middle Name:L
Last Name:TORKILDSEN
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 1:138 HAVERHILL ST
Mailing Address - Street 2:SUITE 104
Mailing Address - City:ANDOVER
Mailing Address - State:MA
Mailing Address - Zip Code:01810-1509
Mailing Address - Country:US
Mailing Address - Phone:978-475-0705
Mailing Address - Fax:978-475-0008
Practice Address - Street 1:138 HAVERHILL ST
Practice Address - Street 2:SUITE 104
Practice Address - City:ANDOVER
Practice Address - State:MA
Practice Address - Zip Code:01810-1509
Practice Address - Country:US
Practice Address - Phone:978-475-0705
Practice Address - Fax:978-475-0008
Is Sole Proprietor?:No
Enumeration Date:2005-12-07
Last Update Date:2007-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA154418207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAAA26686OtherHARVARD PILGRIM HEALTH CA
MA154418OtherTUFTS HEALTH PLAN
MA0195294Medicaid
P00406045OtherRAILROAD MEDICARE
J19536OtherBC/BS OF MASSACHUSETTS
MAG57654Medicare UPIN
MAAA26686OtherHARVARD PILGRIM HEALTH CA