Individual
ANDREY GAGARIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
680 CENTRE ST, BROCKTON, MA 02302-3308
(508) 941-7228
(508) 941-6401
Mailing address
680 CENTRE ST, BROCKTON, MA 02302-3308
(508) 941-7228
(508) 941-6401
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
154838
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1200283
—
MA
Enumeration date
06/21/2006
Last updated
12/07/2011
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