Provider Demographics
NPI:1982687232
Name:BARBIASZ, JANE ELIZABETH (RNCS)
Entity Type:Individual
Prefix:
First Name:JANE
Middle Name:ELIZABETH
Last Name:BARBIASZ
Suffix:
Gender:F
Credentials:RNCS
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Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:170 GOVERNORS AVENUE
Mailing Address - Street 2:LAWRENCE MEMORIAL HOSPITAL PSYCH
Mailing Address - City:MEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:02155
Mailing Address - Country:US
Mailing Address - Phone:781-306-6150
Mailing Address - Fax:781-306-6147
Practice Address - Street 1:170 GOVERNORS AVENUE
Practice Address - Street 2:LAWRENCE MEMORIAL HOSPITAL PSYCH
Practice Address - City:MEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02155
Practice Address - Country:US
Practice Address - Phone:781-306-6150
Practice Address - Fax:781-306-6147
Is Sole Proprietor?:No
Enumeration Date:2005-11-21
Last Update Date:2013-04-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA87280364SP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0808XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MANS0391Medicare ID - Type Unspecified
P09167Medicare UPIN