Provider Demographics
NPI:1821010778
Name:CASELLO, JEAN M (MD)
Entity Type:Individual
Prefix:
First Name:JEAN
Middle Name:M
Last Name:CASELLO
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:512 MAIN ST
Mailing Address - Street 2:2 ND FLOOR
Mailing Address - City:SHREWSBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01545-6405
Mailing Address - Country:US
Mailing Address - Phone:508-842-6898
Mailing Address - Fax:508-842-6898
Practice Address - Street 1:512 MAIN ST
Practice Address - Street 2:2 ND FLOOR
Practice Address - City:SHREWSBURY
Practice Address - State:MA
Practice Address - Zip Code:01545-6405
Practice Address - Country:US
Practice Address - Phone:508-842-6898
Practice Address - Fax:508-842-6898
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-23
Last Update Date:2008-12-04
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Provider Licenses
StateLicense IDTaxonomies
MA78863207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
042472266OtherPRIVATE HEALTHCARE SYSTEM
15450OtherFALLON COMM HEALTH PLAN
784235OtherMVP HEALTH CARE
0404144OtherEVERCARE
043058466002OtherTRICARE
4485083OtherUS HEALTHCARE
J14532OtherBLUE SHIELD INDEMNITY
J14532OtherMEDICARE B
042472266OtherTHREE RIVERS
3120686OtherWELFARE
042472266OtherONE HEALTH PLAN
1162675OtherFIRST HEALTH
124600OtherCIGNA HEALTH PLAN
MA3120686Medicaid
J14532OtherBLUE CARE ELECT
4485083OtherAETNA
AA1260OtherHARVARD PILGRIM HEALTHCAR
J14532OtherBLUE SHIELD HMO BLUE
4485083OtherUS HEALTHCARE
AA1260OtherHARVARD PILGRIM HEALTHCAR