Individual
GUL MOONIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
330 BROOKLINE AVE, DEPT OF RADIOLOGY, NEURORADIOLOGY, WCCB-90, BOSTON, MA 02215-5400
(617) 754-2010
Mailing address
330 BROOKLINE AVE, DEPT OF RADIOLOGY, NEURORADIOLOGY, WCCB-90, BOSTON, MA 02215-5400
(617) 754-2010
Taxonomy
Speciality
Code
Description
License number
State
2085N0700X
Neuroradiology Physician
Primary
276494
NY
2085N0904X
Nuclear Radiology Physician
MD066340L
PA
2085R0202X
Diagnostic Radiology Physician
MD066340L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0017598890005
—
PA
Enumeration date
06/25/2006
Last updated
03/12/2021
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