Healthcare Provider Details

I. General information

NPI: 1932146123
Provider Name (Legal Business Name): JEFFREY L KRAINES M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/31/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55 CAMBRIDGE PARKWAY GENZYME CORP.
CAMBRIDGE MA
02142
US

IV. Provider business mailing address

47 IRVING ST
ARLINGTON MA
02476-6438
US

V. Phone/Fax

Practice location:
  • Phone: 617-591-5547
  • Fax:
Mailing address:
  • Phone: 617-591-5547
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number54522
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: