Provider Demographics
NPI:1609980374
Name:DUMAS, LINDA GAIL (PHD NPC)
Entity Type:Individual
Prefix:DR
First Name:LINDA
Middle Name:GAIL
Last Name:DUMAS
Suffix:
Gender:F
Credentials:PHD NPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1736 BEACON ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLINE
Mailing Address - State:MA
Mailing Address - Zip Code:02445-2124
Mailing Address - Country:US
Mailing Address - Phone:617-566-3221
Mailing Address - Fax:617-738-9020
Practice Address - Street 1:1736 BEACON ST
Practice Address - Street 2:
Practice Address - City:BROOKLINE
Practice Address - State:MA
Practice Address - Zip Code:02445-2124
Practice Address - Country:US
Practice Address - Phone:617-566-3221
Practice Address - Fax:617-738-9020
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-18
Last Update Date:2008-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA97798363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0387801Medicaid
MA0387801Medicaid
MANP3331Medicare UPIN