Provider Demographics
NPI:1932123338
Name:DUFFY, JOCELYN C (MD)
Entity Type:Individual
Prefix:
First Name:JOCELYN
Middle Name:C
Last Name:DUFFY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:140 HAVERHILL ST
Mailing Address - Street 2:NEW ENGLAND MEDICAL GROUP
Mailing Address - City:ANDOVER
Mailing Address - State:MA
Mailing Address - Zip Code:01810
Mailing Address - Country:US
Mailing Address - Phone:978-269-0030
Mailing Address - Fax:978-269-0020
Practice Address - Street 1:140 HAVERHILL ST
Practice Address - Street 2:NEW ENGLAND MEDICAL GROUP
Practice Address - City:ANDOVER
Practice Address - State:MA
Practice Address - Zip Code:01810
Practice Address - Country:US
Practice Address - Phone:978-269-0030
Practice Address - Fax:978-269-0020
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2010-05-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA72041207QA0505X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAJ18494OtherBC/BS
072041OtherTUFT
E72572OtherHARVARD
0105169YPNH02OtherANTHEM BC/BS
26195OtherFALLON
MAJ18494OtherBC/BS
E72572OtherHARVARD
MAE72572Medicare UPIN