Provider Demographics
NPI:1376562447
Name:KRIEGEL, BRUCE J (MD)
Entity type:Individual
Prefix:
First Name:BRUCE
Middle Name:J
Last Name:KRIEGEL
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:960 MASSACHUSETTS AVE
Mailing Address - Street 2:FL 2
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02118-2690
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:830 OAK ST, STE 205W
Practice Address - Street 2:BROCKTON CARDIOLOGY ASSOCIATES
Practice Address - City:BROCKTON
Practice Address - State:MA
Practice Address - Zip Code:02301
Practice Address - Country:US
Practice Address - Phone:508-583-4440
Practice Address - Fax:508-583-7401
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2025-06-02
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Provider Licenses
StateLicense IDTaxonomies
MA54434207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3006166Medicaid
MDA58314Medicare UPIN
MA3006166Medicaid