Organization
JAL PRACTICE
Active
Other names
Emerge Ketamine
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOSEPH GREGORY KLINE BENEDICT (OWNER)
(425) 737-0456
Entity
Organization
Contact information
Practice address
800 W CUMMINGS PARK STE 6250, WOBURN, MA 01801-6372
(617) 569-2112
Mailing address
800 W CUMMINGS PARK STE 6250, WOBURN, MA 01801-6372
(781) 776-1944
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Enumeration date
09/26/2022
Last updated
02/19/2026
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