1932106143 NPI number — DEBORAH M JONAS MD

Table of content: DEBORAH M JONAS MD (NPI 1932106143)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1932106143 NPI number — DEBORAH M JONAS MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
JONAS
Provider First Name:
DEBORAH
Provider Middle Name:
M
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1932106143
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/18/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1177 BOSTON PROVIDENCE TPKE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NORWOOD
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02062-5019
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
781-278-5590
Provider Business Mailing Address Fax Number:
781-769-9017

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1177 BOSTON PROVIDENCE TPKE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NORWOOD
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02062-5019
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
781-278-5590
Provider Business Practice Location Address Fax Number:
781-769-9017
Provider Enumeration Date:
07/01/2005

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: 208000000X , with the licence number:  76883 , 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: 1240284 . This is a "UNITED HEALTHCARE PPO" identifier . This identifiers is of the category "OTHER".
  • Identifier: 760098 . This is a "TUFTS COMMONWEALTH" identifier . This identifiers is of the category "OTHER".
  • Identifier: E30036 . This is a "FIRST SENIORITY" identifier . This identifiers is of the category "OTHER".
  • Identifier: 9324258 . This is a "CIGNA HEALTH CARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 61747 . This is a "HARVARD PILGRIM POS" identifier . This identifiers is of the category "OTHER".
  • Identifier: J13255 . This is a "BLUE SHIELD-INDEMNITY" identifier . This identifiers is of the category "OTHER".
  • Identifier: J13255 . This is a "HMO BLUE CHOICE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0016061 . This is a "NEIGHBORHOOD HEALTH PLAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 3102939 . This is a "MASS HEALTH/DIV OF MED SV" identifier . This identifiers is of the category "OTHER".
  • Identifier: 61747 . This is a "HARVARD PILGRIM" identifier . This identifiers is of the category "OTHER".
  • Identifier: 760098 . This is a "TUFTS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 27548 . This is a "CHILDREN'S MEDICAL SECURI" identifier . This identifiers is of the category "OTHER".
  • Identifier: 760098 . This is a "TUFTS BENEFIT ADMIN" identifier . This identifiers is of the category "OTHER".
  • Identifier: J13255 . This is a "BS-BLUE CARE ELECT" identifier . This identifiers is of the category "OTHER".
  • Identifier: 61747 . This is a "HARVARD PILGRIM PPO" identifier . This identifiers is of the category "OTHER".
  • Identifier: 760098 . This is a "TUFTS TOTAL HEALTH PLAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 9324256 . This is a "HEALTHSOURCE MASSACHUSETT" identifier . This identifiers is of the category "OTHER".




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