Provider Demographics
NPI:1740246198
Name:KENT, JANET ROSALIE (MD)
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:ROSALIE
Last Name:KENT
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:PO BOX 2190
Mailing Address - Street 2:
Mailing Address - City:WEST PEABODY
Mailing Address - State:MA
Mailing Address - Zip Code:01960-7190
Mailing Address - Country:US
Mailing Address - Phone:781-231-7026
Mailing Address - Fax:
Practice Address - Street 1:541 MAIN ST
Practice Address - Street 2:SUITE 212
Practice Address - City:SOUTH WEYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02190-1868
Practice Address - Country:US
Practice Address - Phone:781-682-9970
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA219386208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA2024471Medicaid
MA5496125OtherUNITED HEALTHCARE
MA3544398OtherAETNA
MAAA8110OtherHARVARD PILGRIM HEALTHCA
MA468703OtherTUFTS HEALTH CARE
MAJ27030OtherBLUE CROSS/BLLUE SHIELD
A36157Medicare ID - Type Unspecified
F28419Medicare UPIN