Provider Demographics
NPI:1023012572
Name:JARBEAU, JENNIFER F (MD)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:F
Last Name:JARBEAU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 MILL ROAD
Mailing Address - Street 2:SUITE 180
Mailing Address - City:FAIRHAVEN
Mailing Address - State:MA
Mailing Address - Zip Code:02719-5252
Mailing Address - Country:US
Mailing Address - Phone:508-973-2000
Mailing Address - Fax:508-973-2001
Practice Address - Street 1:400 BALD HILL RD STE 524
Practice Address - Street 2:
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02886-6100
Practice Address - Country:US
Practice Address - Phone:401-737-7313
Practice Address - Fax:401-737-4207
Is Sole Proprietor?:No
Enumeration Date:2005-06-10
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA202597207RC0000X
RIMD11425207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI9003542Medicaid
RI0690035421Medicare PIN
RI069003542Medicare PIN