Provider Demographics
NPI:1902865967
Name:GENTILE, MARGARET E (NP)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:E
Last Name:GENTILE
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 1:354 WAVERLY ST
Mailing Address - Street 2:
Mailing Address - City:FRAMINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:01702-7079
Mailing Address - Country:US
Mailing Address - Phone:508-270-5700
Mailing Address - Fax:
Practice Address - Street 1:354 WAVERLY ST
Practice Address - Street 2:
Practice Address - City:FRAMINGHAM
Practice Address - State:MA
Practice Address - Zip Code:01702-7079
Practice Address - Country:US
Practice Address - Phone:508-270-5700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-20
Last Update Date:2014-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN229678363L00000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0373401Medicaid
MANP3300OtherBLUE CROSS
MAF932OtherHARVARD PILGRIM
MANP3300Medicare ID - Type Unspecified
MAF932OtherHARVARD PILGRIM