Individual
DR. JONATHAN BRUCE KRUSKAL
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD PHD
Contact information
Practice address
1 DEACONESS RD, WEST 302B, BOSTON, MA 02215-5321
(617) 754-2519
Mailing address
59 BALDPATE HILL RD, NEWTON, MA 02459-2826
(617) 754-2519
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
79345
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3126706
—
MA
Enumeration date
05/26/2006
Last updated
07/08/2007
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