| Doctor Name: | MISS TERESA ANN GORE |
| NPI Number: | 1013243138 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | ANP-BC |
| License Number: | RN280238 |
| Business Practice Address: | 11 Nevins St Suite 401 Brighton, MA - 02135 |
| Business Phone Number: | 6177827788 |
| Business Fax Number: | 6177835657 |
| Mailing Address: | 11 Nevins St, 4rd Floor BRIGHTON |
| State: | MA |
| Postal Code: | 02135 |
| Phone Number: | 6179992965 |
| Fax Number: | |
| NPI Enumeration Date: | 10/23/2009 |
| NPI Last Update Date: | 10/22/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LA2200X |
| License Number: | RN280238 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Adult Health |
| Taxonomy Definition: | |