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General NPI Number Information
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NPI Number | 1720214349
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Entity Type | Individual
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Provider Name | CHARU K. JAIN MD
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Gender | Female
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Dates
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Enumeration Date | 06/10/2009
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Last Update Date | 03/14/2025
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Provider Practice Location Address
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Address Line | 830 OAK ST STE 223E
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City | BROCKTON
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State | MA
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Zip | 02301-1191
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Country | US
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Telephone | 508-427-2222
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Fax |
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Provider Business Mailing Address
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Address Line | 960 MASSACHUSETTS AVE
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City | BOSTON
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State | MA
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Zip | 02118-2620
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Country | US
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Telephone | 617-414-4505
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 281404
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License Number State | MA
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