Provider Demographics
NPI:1548210206
Name:MASE, JEANNE M (MD)
Entity Type:Individual
Prefix:DR
First Name:JEANNE
Middle Name:M
Last Name:MASE
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 1:331 E FALMOUTH HWY
Mailing Address - Street 2:
Mailing Address - City:E FALMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02536-6039
Mailing Address - Country:US
Mailing Address - Phone:508-495-0704
Mailing Address - Fax:508-495-0293
Practice Address - Street 1:331 E FALMOUTH HWY
Practice Address - Street 2:
Practice Address - City:E FALMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02536-6039
Practice Address - Country:US
Practice Address - Phone:508-495-0704
Practice Address - Fax:508-495-0293
Is Sole Proprietor?:No
Enumeration Date:2006-05-11
Last Update Date:2014-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA77754207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3117383Medicaid
MA077754OtherTUFTS HEALTH
710585OtherHARVARD PILGRIM
MAJ13982Medicare ID - Type Unspecified
MA077754OtherTUFTS HEALTH