Provider Demographics
NPI:1518044080
Name:GILLIGAN, HANNAH MARIE (MD)
Entity type:Individual
Prefix:
First Name:HANNAH
Middle Name:MARIE
Last Name:GILLIGAN
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:RENAL ASSOCIATES
Mailing Address - Street 2:165 CAMBRIDGE ST STE 301
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02114-2696
Mailing Address - Country:US
Mailing Address - Phone:617-726-5277
Mailing Address - Fax:617-724-8652
Practice Address - Street 1:MGH
Practice Address - Street 2:55 FRUIT ST
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-2696
Practice Address - Country:US
Practice Address - Phone:617-724-8967
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2025-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA78011207R00000X, 207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110061322AMedicaid
MA3195414Medicaid
MAG31350Medicare UPIN
MA3195414Medicaid