Provider Demographics
NPI:1942264387
Name:O'SHEA, JENNIFER (MD)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:O'SHEA
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 1:33 BARTLETT ST
Mailing Address - Street 2:SUITE 305
Mailing Address - City:LOWELL
Mailing Address - State:MA
Mailing Address - Zip Code:01852-1334
Mailing Address - Country:US
Mailing Address - Phone:978-452-2200
Mailing Address - Fax:
Practice Address - Street 1:33 BARTLETT ST
Practice Address - Street 2:SUITE 305
Practice Address - City:LOWELL
Practice Address - State:MA
Practice Address - Zip Code:01852-1334
Practice Address - Country:US
Practice Address - Phone:978-452-2200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-13
Last Update Date:2009-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA153452208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics