Provider Demographics
NPI:1538115985
Name:BROWN, JANE AUDREY (MD)
Entity Type:Individual
Prefix:DR
First Name:JANE
Middle Name:AUDREY
Last Name:BROWN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 JUNIPER LN
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:MA
Mailing Address - Zip Code:02030-2147
Mailing Address - Country:US
Mailing Address - Phone:508-785-1312
Mailing Address - Fax:
Practice Address - Street 1:111 LINCOLN ST
Practice Address - Street 2:
Practice Address - City:NEEDHAM
Practice Address - State:MA
Practice Address - Zip Code:02492-2900
Practice Address - Country:US
Practice Address - Phone:781-444-7186
Practice Address - Fax:781-449-4617
Is Sole Proprietor?:No
Enumeration Date:2006-05-26
Last Update Date:2017-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA55208174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1201375OtherUNITED
MA2802254OtherAETNA
MA055208OtherTUFTS
MAJ05401OtherBCBS
MA20360OtherHPHC
MA3030903Medicaid
MAB10240701OtherCIGNA
MA1201375OtherUNITED