Provider Demographics
NPI:1821288325
Name:KRAKOWER, THALIA MARGALIT (MD)
Entity Type:Individual
Prefix:
First Name:THALIA
Middle Name:MARGALIT
Last Name:KRAKOWER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 TUFTS ST
Mailing Address - Street 2:APT. 3
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02139-4720
Mailing Address - Country:US
Mailing Address - Phone:202-669-9224
Mailing Address - Fax:
Practice Address - Street 1:15 PARKMAN ST
Practice Address - Street 2:WACC 605
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-3117
Practice Address - Country:US
Practice Address - Phone:617-726-7930
Practice Address - Fax:617-724-0331
Is Sole Proprietor?:No
Enumeration Date:2007-07-31
Last Update Date:2011-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA232965207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine