Individual
DR. JAN LESLIE SHIFREN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
55 FRUIT STREET YAW 10, VINCENT OBGYN REPRODUCTIVE MED IVF, BOSTON, MA 02114
(617) 726-8868
(617) 726-4803
Mailing address
PO BOX 9142, MASS GENERAL PHYSICIAN ORGANIZATION, CHARLESTOWN, MA 02129-9142
(617) 726-8868
(617) 724-8882
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
151048
MA
207VE0102X
Reproductive Endocrinology Physician
Primary
151048
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
151048
TUFTS HEALTH PLAN
MA
05
—
3155684
—
MA
01
—
J16855
BCBS MA
MA
Enumeration date
11/16/2005
Last updated
09/10/2012
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