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General NPI Number Information
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NPI Number | 1093685737
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Entity Type | Organization
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Legal Business Name | TEWKSBURY PSYCHIATRY AND KETAMINE PLLC
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Dates
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Enumeration Date | 11/07/2025
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Last Update Date | 11/07/2025
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Provider Practice Location Address
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Address Line | 1445 MAIN ST STE 9
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City | TEWKSBURY
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State | MA
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Zip | 01876-2083
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Country | US
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Telephone | 978-566-6747
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Fax | 978-873-9901
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Provider Business Mailing Address
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Address Line | 1445 MAIN ST STE 9
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City | TEWKSBURY
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State | MA
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Zip | 01876-2083
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Country | US
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Telephone | 978-566-6747
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Fax | 978-873-9901
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Authorized Official
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Title or Position | CO-FOUNDER
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Name | GEORGE KARANJA
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Credential | PMHNP-BC
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Telephone | 978-566-6747
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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