Provider Demographics
NPI:1548767254
Name:GOTTSCHALK, CHELSEA LYNN (MD)
Entity Type:Individual
Prefix:
First Name:CHELSEA
Middle Name:LYNN
Last Name:GOTTSCHALK
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 1:21 WORTHEN RD
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02421-4835
Mailing Address - Country:US
Mailing Address - Phone:781-876-2020
Mailing Address - Fax:
Practice Address - Street 1:21 WORTHEN RD
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:MA
Practice Address - Zip Code:02421-4835
Practice Address - Country:US
Practice Address - Phone:781-876-2020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-09
Last Update Date:2022-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA291267207W00000X
MA279183207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology