Provider Demographics
NPI:1538237490
Name:BIEBER, JANE M (PT)
Entity type:Individual
Prefix:
First Name:JANE
Middle Name:M
Last Name:BIEBER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 NEWBURG ST
Mailing Address - Street 2:
Mailing Address - City:ROSLINDALE
Mailing Address - State:MA
Mailing Address - Zip Code:02131-3319
Mailing Address - Country:US
Mailing Address - Phone:617-325-1208
Mailing Address - Fax:
Practice Address - Street 1:110 NEWBURG ST
Practice Address - Street 2:
Practice Address - City:ROSLINDALE
Practice Address - State:MA
Practice Address - Zip Code:02131-3319
Practice Address - Country:US
Practice Address - Phone:617-325-1208
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA62042251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAY66593OtherBCBS MA PROVIDER ID
MAY66593OtherBCBS MA PROVIDER ID