Organization
MCGILLICUDDY & SUNGARIAN, M.D'S, LLP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GERALD T MCGILLICUDDY M.D. (OWNER)
(508) 752-6381
Entity
Organization
Contact information
Practice address
10 WINTHROP ST, WORCESTER, MA 01604-4467
(508) 752-6381
(508) 795-0407
Mailing address
10 WINTHROP ST, WORCESTER, MA 01604-4467
(508) 752-6381
(508) 795-0407
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
691587
TUFTS HEALTH PLAN
MA
01
—
90509
FALLON HEALTH CARE
MA
05
—
9731041
—
MA
01
—
I00895
NET HI
MA
Enumeration date
04/20/2006
Last updated
11/15/2012
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