Provider Demographics
NPI:1033172275
Name:LIEMAN, JOELLE M (MD)
Entity Type:Individual
Prefix:
First Name:JOELLE
Middle Name:M
Last Name:LIEMAN
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:11 NEVINS ST
Mailing Address - Street 2:MOB SUITE 406
Mailing Address - City:BRIGHTON
Mailing Address - State:MA
Mailing Address - Zip Code:02135-3514
Mailing Address - Country:US
Mailing Address - Phone:617-562-7006
Mailing Address - Fax:617-562-7966
Practice Address - Street 1:11 NEVINS ST
Practice Address - Street 2:MOB SUITE 406
Practice Address - City:BRIGHTON
Practice Address - State:MA
Practice Address - Zip Code:02135-3514
Practice Address - Country:US
Practice Address - Phone:617-562-7006
Practice Address - Fax:617-562-7966
Is Sole Proprietor?:No
Enumeration Date:2006-04-10
Last Update Date:2011-12-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA213731207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
55478OtherFALLON COMMUNITY HEALTH P
J24872OtherBLUE CARE ELECT
042472266OtherPRIVATE HEALTHCARE SYSTEM
042472266OtherTHREE RIVERS
MA0186481Medicaid
042472266OtherUNITED HEALTHCARE
1082702OtherAETNA US HEALTHCARE
131623OtherHARVARD PILGRIM HEALTHCAR
042472266OtherONE HEALTH PLAN
213731OtherTUFTS HEALTH PLAN
382192OtherMVP HEALTH CARE
A34686OtherMEDICARE B
7159183OtherCIGNA HEALTH PLAN
1082702OtherAETNA US HEALTHCARE
A34686Medicare UPIN