Provider Demographics
NPI:1114968286
Name:SCHACHNE, JAY S (MD)
Entity Type:Individual
Prefix:
First Name:JAY
Middle Name:S
Last Name:SCHACHNE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:200 MILL RD
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 1:1800 MAIN RD
Practice Address - Street 2:
Practice Address - City:TIVERTON
Practice Address - State:RI
Practice Address - Zip Code:02878-4625
Practice Address - Country:US
Practice Address - Phone:508-973-9700
Practice Address - Fax:508-674-7378
Is Sole Proprietor?:No
Enumeration Date:2006-06-09
Last Update Date:2020-04-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA54312207RC0000X
RIMD06705207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0003572OtherNEIGHBORHOOD HEALTH
RI200744OtherBLUE CHIP
MA531911OtherAETNA US HEALTH CARE
MA6191339Medicaid
MAMA0014844OtherTRICARE
MA060016807OtherRAILROAD MEDICARE
MA3084OtherHARVARD PILGRIM
RI46361OtherRI BLUE SHIELD
RIJS08267OtherEDS
MA054312OtherTUFTS HEALTH PLAN
MA2501000OtherUNITED HEALTH CARE
MAJ04356OtherBLUE SHIELD
MA000000022176OtherBMC HEALTHNET
MA0003572OtherNEIGHBORHOOD HEALTH
RIJS08267OtherEDS