Individual
TRISHA A GARGIULO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
2000 WASHINGTON ST, SUITE 441 WHITE BLDG, NEWTON, MA 02462-1650
(617) 964-9070
Mailing address
PO BOX 846098, DALLAS, TX 75284-6098
(903) 324-6400
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA07862
TX
363AM0700X
Medical Physician Assistant
2569
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2569
PHYSICIAN ASST LICENSE
MA
Enumeration date
07/23/2008
Last updated
05/15/2023
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