Individual
TASOS GOGAKOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
55 FRUIT ST, BOSTON, MA 02114-2621
(617) 726-2000
Mailing address
19 TABOR PL APT 2, BROOKLINE, MA 02445-7193
(347) 342-7373
Taxonomy
Speciality
Code
Description
License number
State
207ZC0006X
Clinical Pathology Physician
Primary
279748
MA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/28/2019
Last updated
12/16/2022
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