Individual
MRS. TERYN GORGONE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
130 2ND AVE, WALTHAM, MA 02451-1100
(888) 300-2483
Mailing address
1305 YORK AVE, NEW YORK, NY 10021-5663
(646) 962-2764
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2261348
MA
Other
Enumeration date
07/12/2016
Last updated
09/19/2018
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