Basic Information
| Provider Information | |||||||||
| NPI: | 1134412224 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CABLE | ||||||||
| FirstName: | JANA | ||||||||
| MiddleName: | |||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 193 LOCUST ST | ||||||||
| Address2: | |||||||||
| City: | NORTHAMPTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 010602056 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4135848700 | ||||||||
| FaxNumber: | 4135841714 | ||||||||
| Practice Location | |||||||||
| Address1: | 193 LOCUST ST | ||||||||
| Address2: | |||||||||
| City: | NORTHAMPTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 010602056 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4135848700 | ||||||||
| FaxNumber: | 4135841714 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/23/2011 | ||||||||
| LastUpdateDate: | 06/03/2016 | ||||||||
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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 | LP02265 | RI | N | Allopathic & Osteopathic Physicians | Pediatrics | 208000000X | 257886 | MA | Y | Allopathic & Osteopathic Physicians | Pediatrics |
ID Information
| ID | Type | State | Issuer | Description | 110099965A | 05 | MA | MEDICAID |