Provider Demographics
NPI:1134300676
Name:KRAVETZ, AMANDA J (MD)
Entity Type:Individual
Prefix:DR
First Name:AMANDA
Middle Name:J
Last Name:KRAVETZ
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:280 CHESTNUT ST
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01199-1001
Mailing Address - Country:US
Mailing Address - Phone:413-794-5700
Mailing Address - Fax:
Practice Address - Street 1:3500 MAIN ST
Practice Address - Street 2:SUITE 201
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01107-1137
Practice Address - Country:US
Practice Address - Phone:413-794-0900
Practice Address - Fax:413-794-2996
Is Sole Proprietor?:No
Enumeration Date:2007-11-26
Last Update Date:2016-11-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA257472208600000X, 2086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery