Provider Demographics
NPI:1801860192
Name:JAIN, PREETI (MD)
Entity Type:Individual
Prefix:
First Name:PREETI
Middle Name:
Last Name:JAIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
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Mailing Address - Street 1:5 NEPONSET ST FL STREET2
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01606-2714
Mailing Address - Country:US
Mailing Address - Phone:508-368-5532
Mailing Address - Fax:508-595-2021
Practice Address - Street 1:378 MAPLE AVE
Practice Address - Street 2:
Practice Address - City:SHREWSBURY
Practice Address - State:MA
Practice Address - Zip Code:01545-2673
Practice Address - Country:US
Practice Address - Phone:508-595-2513
Practice Address - Fax:508-595-2021
Is Sole Proprietor?:No
Enumeration Date:2006-02-14
Last Update Date:2019-03-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA213254207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
784240OtherMVP HEALTH CARE
AA1210OtherHARVARD PILGRIM HEALTHCAR
J24714OtherBLUE SHIELD HMO BLUE
7537367OtherAETNA US HEALTHCARE
042472266OtherPRIVATE HEALTHCARE SYSTEM
1990558OtherFIRST HEALTH
J24714OtherBLUE SHIELD INDEMNITY
0403366OtherEVERCARE
168050OtherWELFARE
7871454OtherCIGNA HEALTH PLAN
J24714OtherBLUE CARE ELECT
MA168050Medicaid
A33806OtherMEDICARE B
042472266OtherTHREE RIVERS
110241681OtherRAILROAL MEDICARE
168050OtherMEDICAID PCC
043058466004OtherTRICARE CHAMPUS
53067OtherFALLON COMMUNITY HEALTH P
110241681OtherRAILROAL MEDICARE
H59527Medicare UPIN
042472266OtherPRIVATE HEALTHCARE SYSTEM
A33806OtherMEDICARE B