Individual
JANE E CLANCY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
40 HOLLAND ST, SOMERVILLE, MA 02144-2705
(617) 629-6000
(617) 972-5100
Mailing address
147 MILK ST, 9TH FLOOR, BOSTON, MA 02109-4806
(617) 421-2508
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
48219
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000849
NEIGHBORHOOD HEALTH
MA
01
—
1971454-001
CIGNA
MA
05
—
3014118
—
MA
01
—
702782
TUFTS
MA
01
—
B21211801
HEALTHSOURCE
MA
01
—
J04214
BLUE CROSS
MA
01
—
R209
HARVARD PILGRIM
MA
Enumeration date
03/25/2006
Last updated
08/02/2013
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