1346237674 NPI number — DR. JANET D PEARL M.D.

Table of content: DR. JANET D PEARL M.D. (NPI 1346237674)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1346237674 NPI number — DR. JANET D PEARL M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PEARL
Provider First Name:
JANET
Provider Middle Name:
D
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
DICKERMAN
Provider Other First Name:
JANET
Provider Other Middle Name:
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1346237674
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/15/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
600 WORCESTER RD STE 301
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FRAMINGHAM
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
01702-5316
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
508-665-4344
Provider Business Mailing Address Fax Number:
508-665-4355

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
600 WORCESTER RD STE 301
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FRAMINGHAM
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
01702-5316
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
508-665-4344
Provider Business Practice Location Address Fax Number:
508-665-4355
Provider Enumeration Date:
10/03/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207LP2900X , with the licence number:  156037 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 208VP0014X , with the licence number: 156037 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1543040 . This is a "FIRST HEALTH" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 830500942 . This is a "GREAT-WEST HEALTHCARE" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 273800 . This is a "HARVARD PILGRIM" identifier . This identifiers is of the category "OTHER".
  • Identifier: 830500942 . This is a "TRICARE/HEALTH NET FEDERAL SERVICES" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: J18472 . This is a "HMO BLUE NETWORK BLUE" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: J19458 . This is a "MEDICARE ADVANTAGE, PPO" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 050079269 . This is a "RRMC" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 1717907 . This is a "AETNA HMO" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: J18472 . This is a "BLUE CROSS/BLUE SHIELD INDEMNITY" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 3175090 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 7271010 . This is a "AETNA NONHMO" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: G79299 . This is a "HARVARD PILGRIM HEALTHCARE1" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: J18472 . This is a "BCBS DIAGNOSTIC IMAGING" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 156037 . This is a "TUFTS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1779373 . This is a "UNITED HEALTHCARE1" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 2381497 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: J18472 . This is a "BLUE CARE ELECT" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".




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