Provider Demographics
NPI:1841496858
Name:GAMBALE, ANTHONY GERARD (DC)
Entity type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:GERARD
Last Name:GAMBALE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 SALEM ST
Mailing Address - Street 2:
Mailing Address - City:REVERE
Mailing Address - State:MA
Mailing Address - Zip Code:02151-1018
Mailing Address - Country:US
Mailing Address - Phone:781-284-1661
Mailing Address - Fax:178-182-3655
Practice Address - Street 1:454 BROADWAY
Practice Address - Street 2:
Practice Address - City:REVERE
Practice Address - State:MA
Practice Address - Zip Code:02151
Practice Address - Country:US
Practice Address - Phone:781-284-1661
Practice Address - Fax:781-823-6550
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-26
Last Update Date:2016-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1062111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor