Individual
BERNADETTE V JAKOMIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
840 HARRISON AVE, BOSTON, MA 02118-2905
(617) 638-6610
(617) 638-6616
Mailing address
960 MASSACHUSETTS AVE, FL 2, BOSTON, MA 02118-2690
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
015421
ME
2085R0202X
Diagnostic Radiology Physician
Primary
74259
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110050366A
—
MA
05
—
3117609
—
NH
05
—
317980099
—
ME
Enumeration date
11/15/2006
Last updated
04/03/2024
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