Provider Demographics
NPI:1538190335
Name:JURKIEWICZ, ANTONI JOHN (MD)
Entity type:Individual
Prefix:DR
First Name:ANTONI
Middle Name:JOHN
Last Name:JURKIEWICZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:62 BROWN ST STE 203
Mailing Address - Street 2:
Mailing Address - City:HAVERHILL
Mailing Address - State:MA
Mailing Address - Zip Code:01830-6790
Mailing Address - Country:US
Mailing Address - Phone:978-372-7202
Mailing Address - Fax:978-372-6059
Practice Address - Street 1:62 BROWN ST STE 203
Practice Address - Street 2:
Practice Address - City:HAVERHILL
Practice Address - State:MA
Practice Address - Zip Code:01830-6790
Practice Address - Country:US
Practice Address - Phone:978-372-7202
Practice Address - Fax:978-372-6059
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2008-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA215106208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH01Y005348MAO1OtherBCBS/ANTHEM
MA020052367OtherMEDICARE RAILROAD
MA450482175OtherHEALTH CARE VALUE
MA4750452OtherCIGNA
MA28K671OtherEMPIRE BCBS
MAJ25127OtherBCBS
17-01344OtherEVERCARE
MAHMO-2293444OtherAETNA
MA45-0482175OtherWOMENS HEALTH NETWORK
MA450482175OtherGIC IDEMITY/UNKARE
MA043170237OtherTRICARE/CHAMPLD
MA450482175OtherPHCS
MA802376OtherHARVARD PILGRIM
MAPPO-4624394OtherAETNA
MA9721011Medicaid
MA0027487OtherNHP
MA45-0482175OtherUNITED H.C.
MA795038OtherTUFTS
973294OtherNETWORK HEALTH
MAHMO-2293444OtherAETNA
973294OtherNETWORK HEALTH