Dr. Jackie S Fantes, MD
Family Medicine in East Boston, Massachusetts
1275530719- Practice location
- 10 Gove St, East Boston, MA 02128-1920
- Phone
- 617-569-5800
- Fax
- 617-568-4780
- Last updated
- May 8, 2024
Jackie S Fantes is a Family Medicine based in East Boston, MA. Jackie S Fantes practices in East Boston, MA and has the professional credentials of MD. The NPI Number for Jackie S Fantes is 1275530719 and holds a License No. 261649 (MA). The current practice location address for Jackie S Fantes is 10 Gove St, East Boston, MA 02128-1920 and can be reached out via phone at 617-569-5800 and via fax at 617-568-4780.
Provider Profile Details
- NPI Number
- 1275530719
- Provider Name
- Jackie S Fantes
- Credential
- MD
- Provider Entity Type
- Individual
- Gender
- Female
- Address
- 10 Gove St, East Boston, MA 02128-1920
- Phone Number
- 617-569-5800
- Fax Number
- 617-568-4780
- Primary Taxonomy
- Family Medicine · 207Q00000X
- Sole Proprietor
- No
- Provider Enumeration Date
- June 30, 2005
- Last Update Date
- May 8, 2024
- Certification Date
- April 29, 2024
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 10 Gove St
East Boston, MA 02128-1920 - City
- East Boston
- State
- Massachusetts
- Zip
- 02128-1920
- Phone Number
- 617-569-5800
- Fax Number
- 617-568-4780
Provider Business Mailing Address Details
- Address
- 10 Gove St
East Boston, MA 02128-1920 - City
- East Boston
- State
- MA
- Zip
- 02128-1920
- Phone Number
- 617-569-5800
- Fax Number
- 617-568-4780
License Information
- License Number
- 261649
- License State
- MA
- Taxonomy
- Family Medicine · 207Q00000X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
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Frequently Asked Questions
What is the NPI number of Dr. Jackie S Fantes, MD?
The NPI number of Dr. Jackie S Fantes, MD is 1275530719. It was assigned on June 30, 2005 and is currently active in the NPPES registry.
What is the specialty of Dr. Jackie S Fantes, MD?
Dr. Jackie S Fantes, MD is registered under the primary taxonomy Family Medicine (code 207Q00000X), licensed in MA under license number 261649.
Where does Dr. Jackie S Fantes, MD practice?
The practice location is 10 Gove St, East Boston, MA 02128-1920. The office can be reached at 617-569-5800 (phone) or 617-568-4780 (fax).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1275530719 directly on the NPPES registry website.