GREGORY P DECONCILIIS P.A.-C NPI 1366658502

NPI Information

NPI: 1366658502
Provider Name: GREGORY P DECONCILIIS, P.A.-C
Classification: Physician Assistant - 363AS0400X
Entity Type: Individual

Specialization: Surgical

Address:
840 WINTER ST.
BOSTON OUT-PATIENT SURGICAL SUITES, LLC
WALTHAM, MA
ZIP 02451
Phone: (781) 895-4908
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Gregory P Deconciliis, P.A.-C is a surgical physician assistant in Waltham, MA. Gregory P Deconciliis, P.A.-C NPI is 1366658502. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

840 WINTER ST.
BOSTON OUT-PATIENT SURGICAL SUITES, LLC
WALTHAM, MA
ZIP 02451
Phone: (781) 895-4908
Fax: (781) 895-4902

The enumeration date for this NPI number is 5/15/2007 and was last updated on 7/8/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363AS0400X	Physician Assistant	Surgical	1250	MASSACHUSETTS	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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