Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 274479 | MA |
N | 111NI0900X | Internist | 274479 | MA |
Y | 207RA0401X | Internist - Addiction Medicine | 274479 | MA |
NPI | 1962781021 |
---|---|
Provider Name | Dr. Ari Joshua Kriegsman |
First Address | Springfield, MA 01104-2377 |
Second Address | Springfield, MA 01104-2377 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/08/2011 |
Last Update Date | 22/05/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
110139145A | (05) | MA |