Provider Demographics
NPI:1689698375
Name:O'BRIEN, JANE E (MD)
Entity Type:Individual
Prefix:DR
First Name:JANE
Middle Name:E
Last Name:O'BRIEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:163 SOUTH GREAT ROAD
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:MA
Mailing Address - Zip Code:01773
Mailing Address - Country:US
Mailing Address - Phone:781-259-4349
Mailing Address - Fax:617-787-6936
Practice Address - Street 1:FRANCISCAN HOSPITAL FOR CHILDREN
Practice Address - Street 2:30 WARREN ST.
Practice Address - City:BRIGHTON
Practice Address - State:MA
Practice Address - Zip Code:02135
Practice Address - Country:US
Practice Address - Phone:617-254-3800
Practice Address - Fax:617-787-6936
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA56338207SG0201X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207SG0201XAllopathic & Osteopathic PhysiciansMedical GeneticsClinical Genetics (M.D.)
Not Answered208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA6189598Medicare ID - Type Unspecified