Provider Demographics
NPI:1992747976
Name:PHILBIN, A JEROME (MD)
Entity type:Individual
Prefix:
First Name:A
Middle Name:JEROME
Last Name:PHILBIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 2200
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:NH
Mailing Address - Zip Code:03031-4200
Mailing Address - Country:US
Mailing Address - Phone:603-673-9411
Mailing Address - Fax:603-673-9899
Practice Address - Street 1:281 LINCOLN ST
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01605-2138
Practice Address - Country:US
Practice Address - Phone:508-757-1431
Practice Address - Fax:508-334-8154
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA37149207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0006313OtherNEIGHBORHOOD HEALTH
MA2067986Medicaid
MA4710OtherFALLON COMMUNITY HEALTH
MA711123OtherTUFTS HEALTH PLAN
MAN01757OtherBLUE CROSS BLUE SHIELD
MA171035OtherHARVARD PILGRIM
MA352460OtherCENTRAL MA HEALTH CARE
MA98795501OtherNETWORK
MA98795501OtherNETWORK
MA711123OtherTUFTS HEALTH PLAN