Basic Information
| Provider Information | |||||||||
| NPI: | 1609099936 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GLADSKI | ||||||||
| FirstName: | MARGARET | ||||||||
| MiddleName: | |||||||||
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| Credential: | PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 70 MAIN ST | ||||||||
| Address2: | |||||||||
| City: | FLORENCE | ||||||||
| State: | MA | ||||||||
| PostalCode: | 010621487 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4135860400 | ||||||||
| FaxNumber: | 8666440872 | ||||||||
| Practice Location | |||||||||
| Address1: | 21 BRAMBLEBUSH PARK | ||||||||
| Address2: | |||||||||
| City: | FALMOUTH | ||||||||
| State: | MA | ||||||||
| PostalCode: | 02540 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5084955160 | ||||||||
| FaxNumber: | 5084955170 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/11/2007 | ||||||||
| LastUpdateDate: | 04/30/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 04/30/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363A00000X | 001867 | CT | N | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | 363A00000X | 3884 | MA | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
ID Information
| ID | Type | State | Issuer | Description | 003018678 | 05 | CT | MEDICAID |