Jacques, Elise A
Jacques, Elise A is an sole proprietor health care provider with primary practice located at 123 Summer St Suite 650, Worcester MA 01608-1216. She recently has only one registered license in Allopathic & Osteopathic Physicians / Gastroenterology, which is considered as her primary health care specialty. Jacques, Elise A can be contacted via phone (508) 363-9570.Contact Information
Primary practice address
123 Summer St Suite 650
Worcester MA 01608-1216
Phone: (508) 363-9570
Fax: (508) 363-9590
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Gastroenterology | 207RG0100X | 37631 | Massachusetts |
Profile Details
| NPI number | 1619965977 |
|---|---|
| LBN Legal business name | Jacques, Elise A |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Oct 11th, 2005 |
| Last updated | Jan 13th, 2011 - about 13 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1619965977 | NPPES |
| Massachusetts | MEDICAID | 2062925 |
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