Croke, John J

Croke, John J is an individual health care provider with primary practice located at 725 Albany St Shapiro 8, Boston MA 02118-2526. He recently has only one registered license in Allopathic & Osteopathic Physicians / Dermatology, which is considered as his primary health care specialty. Croke, John J can be contacted via phone (617) 638-7420.

Contact Information

Primary practice address
725 Albany St Shapiro 8 Boston MA 02118-2526
Fax: (617) 638-7289
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Dermatology 207N00000X 59427 Massachusetts

Profile Details

NPI number 1013994649
LBN Legal business name Croke, John J
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 23rd, 2005
Last updated May 20th, 2014 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1013994649 NPPES
Massachusetts MEDICAID 110056889A

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