Individual
GISELLE TUNGOL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
55 FRUIT ST, BLAKE 1500, BOSTON, MA 02114
(617) 724-3874
Mailing address
55 FRUIT ST, BLAKE 1500, BOSTON, MA 02114
(617) 721-3874
(617) 643-1781
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA6473
MA
Other
Enumeration date
05/14/2018
Last updated
05/14/2018
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