Kyle Anthony Hansen-Gonzalez

Individual provider Active NPI Student in an Organized Health Care Education/Training Program · South Weymouth, MA

NPI 1093699159 · NPPES record last updated May 24, 2026

Key facts

NPI
1093699159
Entity type
Individual (NPI type 1)
Primary specialty
Student in an Organized Health Care Education/Training Program 390200000X
Practice address
55 Fogg Rd
South Weymouth, MA 02190-2432
Phone
(781) 624-8168
NPI assigned
Aug 2, 2025
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Yes

Addresses

Primary practice location

55 Fogg Rd
South Weymouth, MA 02190-2432

Mailing address

145 Harrison Ave
Boston, MA 02111-1802

Other providers in South Weymouth, MA

All providers in South Weymouth, MA · Student in an Organized Health Care Education/Training Program in Massachusetts

Sources for this page

Verify at the official NPI Registry.