Provider Demographics
NPI:1306183827
Name:BADOLATO, GAIL LAUREEN (NP)
Entity Type:Individual
Prefix:MRS
First Name:GAIL
Middle Name:LAUREEN
Last Name:BADOLATO
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:165 CHARLES RIVER PLAZA
Mailing Address - Street 2:4TH FLOOR, SUITE 404
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02114
Mailing Address - Country:US
Mailing Address - Phone:617-726-2217
Mailing Address - Fax:
Practice Address - Street 1:165 CHARLES RIVER PLZ
Practice Address - Street 2:SUITE 404
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114
Practice Address - Country:US
Practice Address - Phone:617-726-2217
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-04
Last Update Date:2013-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA161625363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner