Individual
ELYSE GIBBONS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
300 LONGWOOD AVE, BOSTON, MA 02115-5724
(781) 856-5779
Mailing address
300 LONGWOOD AVE, BOSTON, MA 02115-5724
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9551
MA
Other
Enumeration date
11/06/2023
Last updated
12/08/2023
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