Provider Demographics
NPI:1760459341
Name:LIGIBEL, JENNIFER A (MD)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:A
Last Name:LIGIBEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:44 BINNEY ST
Mailing Address - Street 2:MAYER 225
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02115-6013
Mailing Address - Country:US
Mailing Address - Phone:617-632-5961
Mailing Address - Fax:617-632-1930
Practice Address - Street 1:44 BINNEY ST
Practice Address - Street 2:MAYER 225
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115-6013
Practice Address - Country:US
Practice Address - Phone:617-632-5961
Practice Address - Fax:617-632-1930
Is Sole Proprietor?:No
Enumeration Date:2006-03-02
Last Update Date:2007-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA159514207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
14733DFOtherHPHC
3004738OtherUNITED HEALTH CARE
65553OtherFALLON COMMUNITY HEALTH P
MAJ24325OtherBLUE CROSS BLUE SHIELD
456343OtherTUFTS
2633179OtherAETNA US HEALTHCARE
7032005OtherCIGNA
MA0151611Medicaid
MA0151611Medicaid
456343OtherTUFTS