1366451734 NPI number — PATTY-ANN KRAJEWSKI M.D.

Table of content: PATTY-ANN KRAJEWSKI M.D. (NPI 1366451734)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1366451734 NPI number — PATTY-ANN KRAJEWSKI M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KRAJEWSKI
Provider First Name:
PATTY-ANN
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1366451734
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/21/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9 INDUSTRIAL RD STE 5
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MILFORD
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
01757-3736
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
508-473-1480
Provider Business Mailing Address Fax Number:
508-473-1210

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1 LUMBER ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HOPKINTON
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
01748-2363
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
508-625-3535
Provider Business Practice Location Address Fax Number:
508-625-1973
Provider Enumeration Date:
08/05/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  213815 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 000000028141 . This is a "BMC HEALTHNET" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 712859 . This is a "HPHC" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: J24780 . This is a "MABC" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 0194506 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 54952 . This is a "FALLON" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 213815 . This is a "TUFTS" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 409678 . This is a "RI BLUE CHIP" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0102611 . This is a "UHC" identifier . This identifiers is of the category "OTHER".
  • Identifier: 3684748001 . This is a "CIGNA" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".




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