Provider Demographics
NPI:1437258605
Name:DANOWITZ, JAY STEVEN (MD)
Entity Type:Individual
Prefix:DR
First Name:JAY
Middle Name:STEVEN
Last Name:DANOWITZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:LAHEY CLINIC
Mailing Address - Street 2:41 MALL RD
Mailing Address - City:BURLINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:01805-0001
Mailing Address - Country:US
Mailing Address - Phone:781-741-5100
Mailing Address - Fax:781-744-7132
Practice Address - Street 1:LAHEY CLINIC
Practice Address - Street 2:41 MALL RD
Practice Address - City:BURLINGTON
Practice Address - State:MA
Practice Address - Zip Code:01805-0001
Practice Address - Country:US
Practice Address - Phone:781-741-5100
Practice Address - Fax:781-744-7132
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2010-10-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA57716207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110044206AMedicaid
MAJ07350Medicare PIN
MAA66589Medicare UPIN
MA110076213Medicare PIN