Provider Demographics
NPI:1386775542
Name:DIANE M. ENGLISH,M.D.,P.C.
Entity type:Organization
Organization Name:DIANE M. ENGLISH,M.D.,P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DIANE
Authorized Official - Middle Name:M
Authorized Official - Last Name:ENGLISH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:617-254-1247
Mailing Address - Street 1:11 NEVINS ST
Mailing Address - Street 2:SUITE 403
Mailing Address - City:BRIGHTON
Mailing Address - State:MA
Mailing Address - Zip Code:02135-3514
Mailing Address - Country:US
Mailing Address - Phone:617-254-1247
Mailing Address - Fax:617-787-9246
Practice Address - Street 1:11 NEVINS ST
Practice Address - Street 2:SUITE 403
Practice Address - City:BRIGHTON
Practice Address - State:MA
Practice Address - Zip Code:02135-3514
Practice Address - Country:US
Practice Address - Phone:617-254-1247
Practice Address - Fax:617-787-9246
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-08
Last Update Date:2009-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA174400000X174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA9727167Medicaid
MA9727167Medicaid
MAB73524Medicare UPIN
MAM13380Medicare ID - Type Unspecified