Provider Demographics
NPI:1639138696
Name:ORENSTEIN, JANE (OD)
Entity Type:Individual
Prefix:
First Name:JANE
Middle Name:
Last Name:ORENSTEIN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:JANE
Other - Middle Name:
Other - Last Name:FRADKIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:999 PROVIDENCE RD
Mailing Address - Street 2:
Mailing Address - City:WHITINSVILLE
Mailing Address - State:MA
Mailing Address - Zip Code:01588
Mailing Address - Country:US
Mailing Address - Phone:508-234-6681
Mailing Address - Fax:508-234-6507
Practice Address - Street 1:999 PROVIDENCE RD
Practice Address - Street 2:
Practice Address - City:WHITINSVILLE
Practice Address - State:MA
Practice Address - Zip Code:01588
Practice Address - Country:US
Practice Address - Phone:508-234-6681
Practice Address - Fax:508-234-6507
Is Sole Proprietor?:No
Enumeration Date:2006-03-20
Last Update Date:2009-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2700152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
756012OtherTUFTS HEALTH PLAN
MAW15621OtherBLUE CROSS OF MASS
MA6000000020OtherHARVARD PILGRIM HEALTHCAR
MA0344109Medicaid
MAW20190OtherBLUE CROSS OF MASS
T59313Medicare UPIN
MA0344109Medicaid