Provider Demographics
NPI:1245397728
Name:LYMAN, JANE STEWART (DPM)
Entity Type:Individual
Prefix:DR
First Name:JANE
Middle Name:STEWART
Last Name:LYMAN
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:474 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:GREENFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01301-3315
Mailing Address - Country:US
Mailing Address - Phone:413-774-3202
Mailing Address - Fax:
Practice Address - Street 1:474 MAIN ST
Practice Address - Street 2:
Practice Address - City:GREENFIELD
Practice Address - State:MA
Practice Address - Zip Code:01301-3315
Practice Address - Country:US
Practice Address - Phone:413-774-3202
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1576213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0338907Medicaid
MA14037OtherHEALTH NEW ENGLAND
MAT25423Medicare UPIN
MA0338907Medicaid