Provider Demographics
NPI:1629600929
Name:JOHN G. GIRAGOS JR. MD LLC
Entity Type:Organization
Organization Name:JOHN G. GIRAGOS JR. MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:GARABED
Authorized Official - Last Name:GIRAGOS
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:617-308-5982
Mailing Address - Street 1:132 INDIAN PIPE LN
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:MA
Mailing Address - Zip Code:01742-4766
Mailing Address - Country:US
Mailing Address - Phone:617-308-5982
Mailing Address - Fax:
Practice Address - Street 1:132 INDIAN PIPE LN
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:MA
Practice Address - Zip Code:01742-4766
Practice Address - Country:US
Practice Address - Phone:617-308-5982
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-05
Last Update Date:2020-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health