Krushell, Jack
Krushell, Jack is an individual health care provider with primary practice located at 40 Holland St Dermatology Dept., Somerville MA 02144-2705. He recently has only one registered license in Allopathic & Osteopathic Physicians / Dermatology, which is considered as his primary health care specialty. Krushell, Jack can be contacted via phone (617) 629-6250.Contact Information
Primary practice address
40 Holland St Dermatology Dept.
Somerville MA 02144-2705
Phone: (617) 629-6250
Fax: (617) 629-6108
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Dermatology | 207N00000X | 74445 | Massachusetts |
Profile Details
| NPI number | 1558328609 |
|---|---|
| LBN Legal business name | Krushell, Jack |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 1st, 2006 |
| Last updated | Jan 25th, 2021 - about 5 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1558328609 | NPPES |
| Massachusetts | MEDICAID | 3204545 |
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