Individual
STANLEY A GORGOL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
198 MAIN ST, SALEM, NH 03079-3113
(603) 898-5864
(603) 898-1207
Mailing address
198 MAIN ST, SALEM, NH 03079-3113
(603) 898-5864
(603) 898-1207
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
128
NH
213E00000X
Podiatrist
1479
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PRK017
HARVARD PILGRIM
MA
01
—
PRK017
HARVARD PILGRIM
NH
01
—
Y71010
MASS BCBS
MA
Enumeration date
11/09/2006
Last updated
01/11/2013
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