Provider Demographics
NPI:1891874947
Name:TRATT, GARY ELLIOT (MD)
Entity Type:Individual
Prefix:DR
First Name:GARY
Middle Name:ELLIOT
Last Name:TRATT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:66 SCHOOL ST
Mailing Address - Street 2:
Mailing Address - City:HYANNIS
Mailing Address - State:MA
Mailing Address - Zip Code:02601
Mailing Address - Country:US
Mailing Address - Phone:508-771-5300
Mailing Address - Fax:508-775-3362
Practice Address - Street 1:66 SCHOOL ST
Practice Address - Street 2:
Practice Address - City:HYANNIS
Practice Address - State:MA
Practice Address - Zip Code:02601
Practice Address - Country:US
Practice Address - Phone:508-771-5300
Practice Address - Fax:508-775-3362
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2011-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA30714207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA60132OtherHARVARD PILGRIM
5388221OtherCIGNA
MATRM07258OtherBLUE SHIELD
11666OtherJOHN HANCOCK COMMONWEALTH
MA2008939Medicaid
111088962OtherRAILROAD RETIREMENT
0400747OtherUNITED HEALTHCARE
0482448OtherUS HEALTHCARE
726169OtherTUFTS
MA2008939Medicaid
0400747OtherUNITED HEALTHCARE