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Individual

GLADYS GIBBS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
133 BROOKLINE AVE, BOSTON, MA 02215-3904
(617) 421-1191
(617) 421-5828
Mailing address
147 MILK ST, PROVIDER ENROLLMENT 9TH FLOOR, BOSTON, MA 02109-4806

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
57364
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0014816
NEIGHBORHOOD HEALTH PLAN
MA
01
057364
TUFTS HEALTH PLAN
MA
01
1832992-007
CIGNA HEALTH CARE
MA
05
3016994
MA
01
G423
HARVARD PILGRIM
MA
01
J06187
BLUE CROSS
MA
Enumeration date
10/05/2006
Last updated
06/15/2011
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