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Individual

GLADYS YASMIN SORTO AVILES

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
3815 WASHINGTON ST STE 2, BOSTON, MA 02130-3760
(617) 983-5800
Mailing address
50 BROOKWAY RD APT 526, BOSTON, MA 02131-1223
(617) 412-7174

Taxonomy

Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100016452235
MA
Enumeration date
02/25/2016
Last updated
02/25/2016
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