Provider Demographics
NPI:1285083972
Name:JASON GRUNES PLLC
Entity type:Organization
Organization Name:JASON GRUNES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:
Authorized Official - Last Name:GRUNES
Authorized Official - Suffix:
Authorized Official - Credentials:M D
Authorized Official - Phone:781-933-3734
Mailing Address - Street 1:2 REHABILITATION WAY
Mailing Address - Street 2:
Mailing Address - City:WOBURN
Mailing Address - State:MA
Mailing Address - Zip Code:01801-6003
Mailing Address - Country:US
Mailing Address - Phone:791-935-5050
Mailing Address - Fax:
Practice Address - Street 1:2 REHABILITATION WAY
Practice Address - Street 2:
Practice Address - City:WOBURN
Practice Address - State:MA
Practice Address - Zip Code:01801-6003
Practice Address - Country:US
Practice Address - Phone:791-935-5050
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-03
Last Update Date:2016-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty