MEDICARE: DR. GAIL K KRAFT M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2080A0000X	Pediatric Adolescent Medicine Physician	33692	MA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	B51046	OTHER	MA	BLUE CROSS / BLUE SHIELD

General Provider Information

NPI Number	:	1174524078
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GAIL K KRAFT M.D.

Provider Business Mailing Address
First Line	:	30 HOLLY CIR
Second Line	:
City	:	WESTON
State	:	MA
Zip	:	02493-1455
Country	:	US
Telephone Number	:	781-235-0560
Fax Number	:	781-235-4345

Provider Business Practice Location Address
First Line	:	30 HOLLY CIR
Second Line	:
City	:	WESTON
State	:	MA
Zip	:	02493-1455
Country	:	US
Telephone Number	:	781-235-0560
Fax Number	:	781-235-4345

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/02/2005
Last Update Date	:	07/08/2007

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