Provider Demographics
NPI:1306968680
Name:VILA, GILSON (RN)
Entity type:Individual
Prefix:MR
First Name:GILSON
Middle Name:
Last Name:VILA
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:49 GERRARD AVE
Mailing Address - Street 2:
Mailing Address - City:EAST LONGMEADOW
Mailing Address - State:MA
Mailing Address - Zip Code:01028-1605
Mailing Address - Country:US
Mailing Address - Phone:413-781-3988
Mailing Address - Fax:
Practice Address - Street 1:2257 MAIN ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01107-1905
Practice Address - Country:US
Practice Address - Phone:413-733-3488
Practice Address - Fax:413-731-7381
Is Sole Proprietor?:No
Enumeration Date:2007-04-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA228966163WA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA0400XNursing Service ProvidersRegistered NurseAddiction (Substance Use Disorder)