Provider Demographics
NPI:1053845412
Name:JAIN, ANKITA (MD)
Entity Type:Individual
Prefix:DR
First Name:ANKITA
Middle Name:
Last Name:JAIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:88 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:TAUNTON
Mailing Address - State:MA
Mailing Address - Zip Code:02780-2465
Mailing Address - Country:US
Mailing Address - Phone:508-967-3838
Mailing Address - Fax:508-967-3828
Practice Address - Street 1:88 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:TAUNTON
Practice Address - State:MA
Practice Address - Zip Code:02780-2465
Practice Address - Country:US
Practice Address - Phone:508-967-3838
Practice Address - Fax:508-967-3828
Is Sole Proprietor?:No
Enumeration Date:2017-04-12
Last Update Date:2022-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA292625207QA0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction Medicine