Basic Information
| Provider Information | |||||||||
| NPI: | 1124080353 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ROHRBACHER | ||||||||
| FirstName: | JAYNE | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 532 SUMNER AVE | ||||||||
| Address2: | |||||||||
| City: | SPRINGFIELD | ||||||||
| State: | MA | ||||||||
| PostalCode: | 011082458 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4137391100 | ||||||||
| FaxNumber: | 4137371643 | ||||||||
| Practice Location | |||||||||
| Address1: | 532 SUMNER AVE | ||||||||
| Address2: | |||||||||
| City: | SPRINGFIELD | ||||||||
| State: | MA | ||||||||
| PostalCode: | 011082458 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4137391100 | ||||||||
| FaxNumber: | 4137371643 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/04/2006 | ||||||||
| LastUpdateDate: | 11/30/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | 71542 | MA | Y | Allopathic & Osteopathic Physicians | Pediatrics | 208000000X | 13327 | NH | N | Allopathic & Osteopathic Physicians | Pediatrics |
ID Information
| ID | Type | State | Issuer | Description | 000000049358 | 01 | MA | BMC HEALTH NET PLAN | OTHER | 1124080353 | 01 | MA | TUFTS (BAYCARE PARTNERS) | OTHER | 71542 | 01 | MA | LICENSE | OTHER | 6247326 | 01 | MA | CIGNA | OTHER | AA126382 | 01 | MA | HARVARD PILGRIM | OTHER | 1124080353 | 01 | MA | NHP | OTHER | 38150 | 01 | MA | HNE | OTHER | BR1969902 | 01 | MA | DEA CSR | OTHER | MR0617918A | 01 | MA | STATE CSR | OTHER | 071542 | 01 | MA | CONNECTICARE | OTHER | 1124080353 | 01 | MA | FALLON CARE (BAYCARE PARTNERS) | OTHER | 96632902 | 01 | MA | NETWORK HEALTH | OTHER |