Provider Demographics
NPI:1023081320
Name:HENNESSEY, FRANCINE M (MD)
Entity type:Individual
Prefix:DR
First Name:FRANCINE
Middle Name:M
Last Name:HENNESSEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 9142
Mailing Address - Street 2:MASS GENERAL PHYSICIAN ORGANIZATION
Mailing Address - City:CHARLESTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:02129-9142
Mailing Address - Country:US
Mailing Address - Phone:617-724-0287
Mailing Address - Fax:617-726-2894
Practice Address - Street 1:74 LOOMIS STREET
Practice Address - Street 2:PATRIOT PEDIATRICS
Practice Address - City:BEDFORD
Practice Address - State:MA
Practice Address - Zip Code:01730-2248
Practice Address - Country:US
Practice Address - Phone:781-674-2900
Practice Address - Fax:781-860-6226
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA60432208000000X, 2080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered208000000XAllopathic & Osteopathic PhysiciansPediatrics
Not Answered2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAJ11477OtherBCBS MA
MA3080714Medicaid
MA718556OtherTUFTS HEALTH PLAN
MAJ11477OtherBCBS MA
E95360Medicare UPIN