Provider Demographics
NPI:1437418555
Name:GILLIS, SHARON DEBORAH (JD)
Entity Type:Individual
Prefix:MS
First Name:SHARON
Middle Name:DEBORAH
Last Name:GILLIS
Suffix:
Gender:F
Credentials:JD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 NOBSCOT RD
Mailing Address - Street 2:
Mailing Address - City:NEWTON CENTRE
Mailing Address - State:MA
Mailing Address - Zip Code:02459-1323
Mailing Address - Country:US
Mailing Address - Phone:617-964-2444
Mailing Address - Fax:
Practice Address - Street 1:271 HUNTINGTON AVE
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115-4506
Practice Address - Country:US
Practice Address - Phone:617-267-3700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-09
Last Update Date:2012-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program