Individual
BRIAN MONGILLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
14 PROSPECT ST, MILFORD, MA 01757-3003
(508) 422-2250
Mailing address
26 OLD BROOK RD, SHREWSBURY, MA 01545-5409
(508) 845-0127
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
73402
MA
Other
Enumeration date
12/05/2006
Last updated
07/08/2007
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