Provider Demographics
NPI:1326139759
Name:ARNOLD J. KROLL,M.D.,P.C.
Entity Type:Organization
Organization Name:ARNOLD J. KROLL,M.D.,P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ARNOLD
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:KROLL
Authorized Official - Suffix:I
Authorized Official - Credentials:MD
Authorized Official - Phone:617-742-8390
Mailing Address - Street 1:0 LONGFELLOW PL
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02114-2401
Mailing Address - Country:US
Mailing Address - Phone:617-742-8390
Mailing Address - Fax:617-742-9288
Practice Address - Street 1:0 LONGFELLOW PL
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-2401
Practice Address - Country:US
Practice Address - Phone:617-742-8390
Practice Address - Fax:617-742-9288
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ARNOLD J. KROLL MD PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-09-28
Last Update Date:2013-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA28444174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAM11834Medicare PIN