Healthcare Provider Details

I. General information

NPI: 1629600929
Provider Name (Legal Business Name): JOHN G. GIRAGOS JR. MD LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/05/2020
Last Update Date: 02/05/2020
Certification Date: 02/05/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

132 INDIAN PIPE LN
CONCORD MA
01742-4766
US

IV. Provider business mailing address

132 INDIAN PIPE LN
CONCORD MA
01742-4766
US

V. Phone/Fax

Practice location:
  • Phone: 617-308-5982
  • Fax:
Mailing address:
  • Phone: 617-308-5982
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. JOHN GARABED GIRAGOS JR.
Title or Position: PROVIDER
Credential: MD
Phone: 617-308-5982