Provider Demographics
NPI:1962900290
Name:GAO, MENG (NP)
Entity type:Individual
Prefix:
First Name:MENG
Middle Name:
Last Name:GAO
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:479 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:HOLLISTON
Mailing Address - State:MA
Mailing Address - Zip Code:01746-1828
Mailing Address - Country:US
Mailing Address - Phone:508-429-2377
Mailing Address - Fax:508-429-2607
Practice Address - Street 1:479 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:HOLLISTON
Practice Address - State:MA
Practice Address - Zip Code:01746-1828
Practice Address - Country:US
Practice Address - Phone:508-429-2377
Practice Address - Fax:508-429-2607
Is Sole Proprietor?:No
Enumeration Date:2018-02-01
Last Update Date:2023-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2314300363LF0000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily