Individual provider Active NPI

Janie L Kritzman, PHD

  • Clinical Psychologist
  • Medford, MA
National Provider Identifier
1689795999
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
7213 Issued in MA
Practice address
92 High St
Medford, MA 02155-3850
Phone
(781) 393-8889
Fax
(781) 306-3948
NPI assigned
Apr 3, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 7213 MA Primary

Addresses

Primary practice location

92 High St
Medford, MA 02155-3850

Mailing address

24 Warwick Rd
Brookline, MA 02445-2003
Phone (781) 393-8889

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120409000402 MA Practitioner - Clinical Psychologist 3072774611 Practice locations: Medford, MA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
7213MAMDClinical Psychologist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1175558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1689795999",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 WARWICK RD",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024452003",
            "telephone_number": "781-393-8889",
            "fax_number": "781-396-3948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "92 HIGH ST",
            "city": "MEDFORD",
            "state": "MA",
            "postal_code": "021553850",
            "telephone_number": "781-393-8889",
            "fax_number": "781-306-3948"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRITZMAN",
        "first_name": "JANIE",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MA",
            "license": "7213",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Medford, MA

Sources for this page

Verify at the official NPI Registry.