Individual
MARY GILMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
10 LINCOLN SQ, WORCESTER, MA 01608
(508) 373-5830
(508) 519-5512
Mailing address
10 LINCOLN SQ, WORCESTER, MA 01608-1135
(508) 373-5830
(508) 519-5512
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4772
MA
152W00000X
Optometrist
OEG002201
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110085990A
—
MA
Enumeration date
08/25/2009
Last updated
07/09/2019
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