Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 223973 | MA |
N | 111NI0900X | Internist | 223973 | MA |
Y | 207RH0002X | Hospice and Palliative Medicine | 223973 | MA |
NPI | 1245221480 |
---|---|
Provider Name | Dr. Juliet Christine Jacobsen |
First Address | Charlestown, MA 02129-9142 |
Second Address | Boston, MA 02114-2696 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/11/2005 |
Last Update Date | 26/02/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2101076 | (05) | MA |
468394 | TUFTS HEALTH PLAN (01) | MA |
I32567 | (02) | |
J28570 | BCBS MA (01) | MA |