Basic Information
| Provider Information | |||||||||
| NPI: | 1689698375 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | O'BRIEN | ||||||||
| FirstName: | JANE | ||||||||
| MiddleName: | E. | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 163 SOUTH GREAT ROAD | ||||||||
| Address2: | |||||||||
| City: | LINCOLN | ||||||||
| State: | MA | ||||||||
| PostalCode: | 01773 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7812594349 | ||||||||
| FaxNumber: | 6177876936 | ||||||||
| Practice Location | |||||||||
| Address1: | FRANCISCAN HOSPITAL FOR CHILDREN | ||||||||
| Address2: | 30 WARREN ST. | ||||||||
| City: | BRIGHTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 02135 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6172543800 | ||||||||
| FaxNumber: | 6177876936 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/26/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207SG0201X | 56338 | MA | X | Allopathic & Osteopathic Physicians | Medical Genetics | Clinical Genetics (M.D.) | 208000000X | 56338 | MA | X | Allopathic & Osteopathic Physicians | Pediatrics |
No ID Information.