1285692897 NPI number — DR. JEANNE BARI ACKMAN M.D.

Table of content: TRISHALA MEGHAL M.D. (NPI 1255691135)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1285692897 NPI number — DR. JEANNE BARI ACKMAN M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ACKMAN
Provider First Name:
JEANNE
Provider Middle Name:
BARI
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:
ACKMAN
Provider Other First Name:
JEANNE
Provider Other Middle Name:
BARI
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
M.D.
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1285692897
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/25/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
23 NOBSCOT RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WESTON
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02493-1146
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
617-724-4254
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
55 FRUIT ST
Provider Second Line Business Practice Location Address:
MGH DEPARTMENT OF RADIOLOGY, FOUNDERS HOUSE 2
Provider Business Practice Location Address City Name:
BOSTON
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02114-2621
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
617-724-4254
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/03/2006

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: 2085R0202X , with the licence number:  154307 , 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: 0028726 . This is a "NEIGHBORHOOD HEALTH PLAN" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 250726 . This is a "HARVARD PILGRIM HEALTH CA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 3174212 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 000000027977 . This is a "BMC HEALTHNET" identifier . This identifiers is of the category "OTHER".
  • Identifier: 39133 . This is a "FALLON COMMUNITY HEALTH P" identifier . This identifiers is of the category "OTHER".
  • Identifier: 774897 . This is a "TUFTS HEALTH PLAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: J18419 . This is a "BLUE SHIELD OF MA" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 300137474 . This is a "RAILROAD MEDICARE" identifier . This identifiers is of the category "OTHER".




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