Provider Demographics
NPI:1588622559
Name:PASCOE, JEAN R (MD)
Entity Type:Individual
Prefix:
First Name:JEAN
Middle Name:R
Last Name:PASCOE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:133 BROOKLINE AVE
Mailing Address - Street 2:ADULT URGENT CARE
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02215-3904
Mailing Address - Country:US
Mailing Address - Phone:617-421-1194
Mailing Address - Fax:
Practice Address - Street 1:133 BROOKLINE AVE
Practice Address - Street 2:ADULT URGENT CARE
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02215-3904
Practice Address - Country:US
Practice Address - Phone:617-421-1194
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-01
Last Update Date:2019-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA51479207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAHV0024OtherHARVARD PILGRIM
MAR01083OtherBLUE CROSS
MA760961OtherTUFTS
MA0016844OtherNEIGHBORHOOD HEALTH
MA6172679Medicaid
MA0016844OtherNEIGHBORHOOD HEALTH
MAR01083OtherBLUE CROSS