MEDICARE: DR. JANE ELLEN DRESKIN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician	44223	MA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	704034	OTHER	MA	TUFTS HEALTH PLAN

General Provider Information

NPI Number	:	1396726238
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JANE ELLEN DRESKIN MD

Provider Business Mailing Address
First Line	:	PO BOX 9142
Second Line	:	MASS GENERAL PHYSICIAN ORGANIZATION
City	:	CHARLESTOWN
State	:	MA
Zip	:	02129-9142
Country	:	US
Telephone Number	:	617-889-5837
Fax Number	:	617-889-8509

Provider Business Practice Location Address
First Line	:	151 EVERETT AVE
Second Line	:	CHELSEA HEALTHCARE CENTER CHC
City	:	CHELSEA
State	:	MA
Zip	:	02150-1812
Country	:	US
Telephone Number	:	617-889-8537
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/08/2005
Last Update Date	:	07/31/2012

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