Dimitrakoff, Jordan D

Dimitrakoff, Jordan D is an sole proprietor health care provider with primary practice located at 330 Brookline Ave Ks-316 Beth Israel Deconess Medical Center, Boston MA 02215. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Adolescent Medicine, Allopathic & Osteopathic Physicians / Urology. Allopathic & Osteopathic Physicians / Internal Medicine is his primary health care specialty. Dimitrakoff, Jordan D can be contacted via phone (617) 667-2051.

Contact Information

Primary practice address
330 Brookline Ave Ks-316 Beth Israel Deconess Medical Center Boston MA 02215
Phone: (617) 667-2051
Fax: (617) 249-2035
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X PENDING Massachusetts
Allopathic & Osteopathic Physicians / Adolescent Medicine 207RA0000X PENDING Massachusetts
Allopathic & Osteopathic Physicians / Urology 208800000X PENDING Massachusetts
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 244988 Massachusetts
Allopathic & Osteopathic Physicians / Urology 208800000X 244988 Massachusetts

Profile Details

NPI number 1225272412
LBN Legal business name Dimitrakoff, Jordan D
Credentials M.D., PH.D.
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 1st, 2009
Last updated May 23rd, 2011 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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