Provider Demographics
NPI:1245429588
Name:JANET C LIMKE MD LLC
Entity Type:Organization
Organization Name:JANET C LIMKE MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD LLC
Authorized Official - Prefix:
Authorized Official - First Name:JANET
Authorized Official - Middle Name:C
Authorized Official - Last Name:LIMKE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:508-865-0890
Mailing Address - Street 1:PO BOX 226
Mailing Address - Street 2:
Mailing Address - City:SUTTON
Mailing Address - State:MA
Mailing Address - Zip Code:01590
Mailing Address - Country:US
Mailing Address - Phone:508-865-0890
Mailing Address - Fax:508-865-5226
Practice Address - Street 1:250 POND ST
Practice Address - Street 2:BRAINTREE REHAB HOSPITAL
Practice Address - City:BRAINTREE
Practice Address - State:MA
Practice Address - Zip Code:02184
Practice Address - Country:US
Practice Address - Phone:781-348-2141
Practice Address - Fax:781-380-4809
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-23
Last Update Date:2007-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA59142208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0159301Medicaid
MA0159301Medicaid