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Provider Information for 1407098767

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

INGRID GANSKE M.D.

Gender: FEMALE

Individual NPI: 1407098767

Calendar   Last Updated:  2016-12-19
  Certification Date: 

Details

Name Value
NPI 1407098767
Enumeration Date 2009-04-01
NPI Type 1 - Individual
Sole Proprietor NO
Status Active
Mailing Address 300 LONGWOOD AVE ENDERS 123
BOSTON, MA 02115-5724
United States

Phone: 617-355-1463 | Fax:
View Map External Link
Primary Practice Address 330 LONGWOOD AVE
BOSTON, MA 02115-5746
United States

Phone: 617-355-1463 | 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 2086S0122X - Surgery Plastic and Reconstructive Surgery MA 262488
No 2086S0122X - Surgery Plastic and Reconstructive Surgery ME MD21076