Organization
GARDEN CITY PEDIATRIC ASSOC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JACOB D KRITEMAN MD (PHYSICIAN)
(978) 527-4980
Entity
Organization
Contact information
Practice address
83 HERRICK ST, STE 1003, BEVERLY, MA 01915
(978) 927-4980
Mailing address
83 HERRICK ST, STE 1003, BEVERLY, MA 01915
(978) 927-4980
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9707433
—
MA
01
—
M12092
BCBS
—
Enumeration date
09/06/2006
Last updated
10/10/2007
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