MR. GORDON CHARLES SIEK (NPI# 1730705476) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730705476 |
| Entity Type | Individual |
| Full Name | MR. GORDON CHARLES SIEK |
| Credential | PHD |
| Practice Address |
27 Drydock Ave Flr 3 Boston MA 02210-2382 |
| Practice Telephone | 8575230154 |
| Mailing Telephone | 8575230154 |
| Enumeration Date | 2020-06-18 |
| Last Update Date | 2020-06-18 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 247ZC0005X |
Pathology Specialization: Clinical Laboratory Director, Non-physician |
Technologists, Technicians & Other Technical Service Providers |
| Street Address |
27 DRYDOCK AVE FLR 3 |
| City | BOSTON |
| State | MA |
| Zip Code | 02210-2382 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104339308 | Jand Inc. | Eyewear Supplier (Equipment, not the service) | 72 Seaport Blvd, Boston, MA 02210 | 2017-11-09 |
| 1548655541 | Virtudent Ma LLC | Dentist | 21 Drydock Ave. 6th Floor, C/o Masschallenge, Boston, MA 02210 | 2015-04-06 |
| 1013310242 | Ella Osborn | Dentist | 268 Summer St, Boston, MA 02210 | 2014-10-02 |
| 1215231071 | Healthworks Med Group of Massachusetts P C | Clinic/Center | 245 Summer St Ste 1100, Boston, MA 02210 | 2011-01-07 |
| 1225228323 | Lisa R Hirschhorn | Internal Medicine | Jsi Research & Training, 44 Farnsworth Street, Boston, MA 02210 | 2007-07-26 |
| 1003038365 | Ma Department of Youth Services | Public Health or Welfare | 27 Wormwood Street, Suite 400, Boston, MA 02210 | 2007-05-03 |
| 1043365786 | Carol I Williams | Surgery | Mcmcllc, 88 Black Falcon Pier, Boston, MA 02210 | 2007-01-24 |
| 1801955265 | Anjali Aggarwal | Anesthesiology | One Park Lane, Apartment #1005, Boston, MA 02210 | 2006-12-08 |
| 1609987312 | Morton Bruce Rosenberg | Dentist | 25 Channel Center Street, #802, Boston, MA 02210 | 2006-08-31 |
| 1063446714 | Robert C Parke | Family Medicine | Boston Meps Medical Section, 495 Summer Street, Boston, MA 02210 | 2006-07-10 |
| Find all providers in zip 02210 | ||||
| Taxonomy Code | 247ZC0005X |
| Grouping | Technologists, Technicians & Other Technical Service Providers |
| Classification | Pathology |
| Specialization | Clinical Laboratory Director, Non-physician |
| An individual who is state-licensed as a clinical laboratory director and meets the qualifications in the Clinical Laboratory Improvement Amendments of 1988 for non-physicians (non-MD/DO) as defined in the CFR 42 Part 493.1405. |
| Notes: Source: National Uniform Claim Committee [1/1/2007: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649570383 | Zhenyuan Wang | Pathology | 700 Albany St, W408, Boston, MA 02118-2518 | 2010-10-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255899670 | Magalie Leduc | Pathology | 99 Conifer Hill Dr, Danvers, MA 01923-1193 | 2019-03-05 |
Please comment or provide details below to improve the information on MR. GORDON CHARLES SIEK.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.