Provider Demographics
NPI:1356437412
Name:GURVITS, KATRINA (DC)
Entity type:Individual
Prefix:DR
First Name:KATRINA
Middle Name:
Last Name:GURVITS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:YEKATERINA
Other - Middle Name:
Other - Last Name:KORETSKY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DC
Mailing Address - Street 1:651 WASHINGTON ST
Mailing Address - Street 2:SUITE 110
Mailing Address - City:BROOKLINE
Mailing Address - State:MA
Mailing Address - Zip Code:02446-4517
Mailing Address - Country:US
Mailing Address - Phone:617-232-0240
Mailing Address - Fax:617-232-0213
Practice Address - Street 1:651 WASHINGTON ST
Practice Address - Street 2:SUITE 110
Practice Address - City:BROOKLINE
Practice Address - State:MA
Practice Address - Zip Code:02446-4517
Practice Address - Country:US
Practice Address - Phone:617-232-0240
Practice Address - Fax:617-232-0213
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2009-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2185111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA350496OtherHARVARD PILGRIM
MA4541452-002OtherCIGNA
MAY36551OtherBLUE CROSS BLUE SHIELD
MA44-00568OtherUNITED HEALTHCARE
MA2228316OtherAETNA US HEALTHCARE
MA002185OtherTUFTS
MA4541452-002OtherCIGNA
MAGUY45193Medicare ID - Type Unspecified