Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 257472 | MA |
N | 208600000X | Surgeon | 257472 | MA |
Y | 2086S0129X | Vascular Surgeon | 257472 | MA |
NPI | 1134300676 |
---|---|
Provider Name | Dr. Amanda J Kravetz |
First Address | Springfield, MA 01199-1001 |
Second Address | Springfield, MA 01107-1137 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/11/2007 |
Last Update Date | 15/11/2016 |