Individual
MR. JARED CHASE GROCHOWSKY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
330 BROOKLINE AVE, DEACONESS 311, BOSTON, MA 02215-5400
(617) 754-0100
(617) 754-0230
Mailing address
330 BROOKLINE AVE, DEACONESS 311, BOSTON, MA 02215-5400
(617) 754-0100
(617) 754-0230
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
243958
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
243958
LIMITED LICENSE
MA
Enumeration date
06/17/2010
Last updated
06/17/2010
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