Basic Information
| Provider Information | |||||||||
| NPI: | 1376287318 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GULKAS | ||||||||
| FirstName: | SAMET | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | ONE JOSLIN PLACE | ||||||||
| Address2: | BEETHAM EYE INSTITUTE-JOSLIN DIABETES CENTER | ||||||||
| City: | BOSTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 02215 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6175901498 | ||||||||
| FaxNumber: | 6173092545 | ||||||||
| Practice Location | |||||||||
| Address1: | ONE JOSLIN PLACE | ||||||||
| Address2: | BEETHAM EYE INSTITUTE-JOSLIN DIABETES CENTER | ||||||||
| City: | BOSTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 02215 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6175901498 | ||||||||
| FaxNumber: | 6173092545 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/26/2022 | ||||||||
| LastUpdateDate: | 04/26/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 04/26/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207WX0107X | 292280 | MA | Y |
No ID Information.