Provider Demographics
NPI:1982672267
Name:ISEN, JEFFREY S (MD)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:S
Last Name:ISEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 WOODWARD RD
Mailing Address - Street 2:
Mailing Address - City:FRAMINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:01701-7854
Mailing Address - Country:US
Mailing Address - Phone:508-846-5993
Mailing Address - Fax:
Practice Address - Street 1:16 WOODWARD RD
Practice Address - Street 2:
Practice Address - City:FRAMINGHAM
Practice Address - State:MA
Practice Address - Zip Code:01701-7854
Practice Address - Country:US
Practice Address - Phone:508-846-5993
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-10
Last Update Date:2012-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA54840208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
042472266OtherPRIVATE HEALTHCARE SYSTEM
1060773OtherFIRST HEALTH
042472266OtherHEALTHCARE VALUE MNGMT
MA3100316Medicaid
784031OtherMVP HEALTH CARE
7869344OtherAETNA US HEALTHCARE
J12368OtherBLUE SHIELD INDEMNITY
1900126OtherEVERCARE
29185OtherCHILDRENS MEDICAL SEC
29185OtherHEALTHY START
J12368OtherBLUE CARE ELECT
J12368OtherMEDICARE B
3100316OtherMEDICAID WELFARE
5169476OtherCIGNA HEALTH PLAN
042472266OtherONE HEALTH PLAN
9900197OtherFALLON COMM HEALTH PLAN
AA6078OtherHARVARD PILGRIM HLTH CARE
J12368OtherBLUE SHIELD HMO BLUE
AA6078OtherHARVARD PILGRIM HLTH CARE
5169476OtherCIGNA HEALTH PLAN
MAJ12368Medicare ID - Type Unspecified