Provider Demographics
NPI:1811637887
Name:GERVAIS, EMILY MAYA EAKIN (MD)
Entity type:Individual
Prefix:DR
First Name:EMILY
Middle Name:MAYA EAKIN
Last Name:GERVAIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:EMILY
Other - Middle Name:
Other - Last Name:EAKIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:72 E CONCORD ST BLDG 5TH
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02118-2642
Mailing Address - Country:US
Mailing Address - Phone:617-638-8442
Mailing Address - Fax:617-638-8409
Practice Address - Street 1:72 E CONCORD ST BLDG 5TH
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02118-2642
Practice Address - Country:US
Practice Address - Phone:617-638-8442
Practice Address - Fax:617-638-8409
Is Sole Proprietor?:No
Enumeration Date:2022-03-29
Last Update Date:2023-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program