Healthcare Provider Details

I. General information

NPI: 1417195496
Provider Name (Legal Business Name): JOSHUA KREMBS D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/28/2009
Last Update Date: 03/01/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

42 SUMMER ST SUITE 301
PITTSFIELD MA
01201-4624
US

IV. Provider business mailing address

42 SUMMER ST SUITE 301
PITTSFIELD MA
01201-4624
US

V. Phone/Fax

Practice location:
  • Phone: 413-442-0085
  • Fax: 413-464-9143
Mailing address:
  • Phone: 413-442-0085
  • Fax: 413-464-9143

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code204D00000X
TaxonomyNeuromusculoskeletal Medicine & OMM Physician
License Number239412
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: