Internicola, Jeanne Mary
Internicola, Jeanne Mary is an individual health care provider with primary practice located at 210 Old Colony Ave , South Boston MA 02127-2413. She recently has only one registered license in Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), which is considered as her primary health care specialty. Internicola, Jeanne Mary can be contacted via phone (617) 268-5000.Contact Information
Primary practice address
210 Old Colony Ave
South Boston MA 02127-2413
Phone: (617) 268-5000
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) | 101YA0400X | 1915 | Massachusetts |
Profile Details
| NPI number | 1306345483 |
|---|---|
| LBN Legal business name | Internicola, Jeanne Mary |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 5th, 2018 |
| Last updated | Feb 5th, 2018 - about 8 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1306345483 | NPPES |
| Massachusetts | MEDICAID | 043220123 |
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