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Provider Information for 1093974131

Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know

DR. COURTNEY AYSHE GIDENGIL M.D.

Gender: FEMALE

Individual NPI: 1093974131

Calendar   Last Updated:  2010-06-24
  Certification Date: 

Details

Name Value
NPI 1093974131
Enumeration Date 2008-06-04
NPI Type 1 - Individual
Sole Proprietor NO
Status Active
Mailing Address 300 LONGWOOD AVE DIVISION OF INFECTIOUS DISEASES
BOSTON, MA 02115-5724
United States

Phone: 617-355-8956 | Fax:
View Map External Link
Primary Practice Address 300 LONGWOOD AVE AU-522
BOSTON, MA 02115-5724
United States

Phone: 617-355-8956 | Fax:
View Map External Link
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 2080P0208X - Pediatrics Pediatric Infectious Diseases MA 239013