Basic Information
Provider Information
NPI: 1245691146
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: OAKLEY
FirstName: ERIN
MiddleName: MARGARET
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: GALLIVAN
OtherFirstName: ERIN
OtherMiddleName: MARGARET
OtherNamePrefix: MISS
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType: 1
Mailing Information
Address1: 1 BOSTON MEDICAL CTR PL
Address2:  
City: BOSTON
State: MA
PostalCode: 021182908
CountryCode: US
TelephoneNumber: 6176388000
FaxNumber:  
Practice Location
Address1: 1 BOSTON MEDICAL CTR PL
Address2:  
City: BOSTON
State: MA
PostalCode: 021182908
CountryCode: US
TelephoneNumber: 6176388000
FaxNumber:  
Other Information
ProviderEnumerationDate: 03/19/2016
LastUpdateDate: 06/20/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207P00000X267502MAY Allopathic & Osteopathic PhysiciansEmergency Medicine 

No ID Information.


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