Provider Demographics
NPI:1386626299
Name:BHATHENA, JASMIN F (MD)
Entity Type:Individual
Prefix:DR
First Name:JASMIN
Middle Name:F
Last Name:BHATHENA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:2 ESSEX CENTER DR
Mailing Address - Street 2:
Mailing Address - City:PEABODY
Mailing Address - State:MA
Mailing Address - Zip Code:01960-2926
Mailing Address - Country:US
Mailing Address - Phone:978-977-4300
Mailing Address - Fax:978-977-4313
Practice Address - Street 1:2 ESSEX CENTER DR
Practice Address - Street 2:
Practice Address - City:PEABODY
Practice Address - State:MA
Practice Address - Zip Code:01960-2926
Practice Address - Country:US
Practice Address - Phone:978-977-4300
Practice Address - Fax:978-977-4313
Is Sole Proprietor?:No
Enumeration Date:2005-11-16
Last Update Date:2021-01-06
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Provider Licenses
StateLicense IDTaxonomies
MA82921208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAJ19587OtherBLUE CROSS BLUE SHIEL
MA3191729Medicaid