Basic Information
| Provider Information | |||||||||
| NPI: | 1992712178 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | JANNE | ||||||||
| FirstName: | PASI ANTERO | ||||||||
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| Credential: | MD PHD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 450 BROOKLINE AVE | ||||||||
| Address2: | DANA FARBER CANCER INSTITUTE | ||||||||
| City: | BOSTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 022155418 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6176326049 | ||||||||
| FaxNumber: | 6176325786 | ||||||||
| Practice Location | |||||||||
| Address1: | 44 BINNEY ST | ||||||||
| Address2: | DANA FARBER CANCER INSTITUTE | ||||||||
| City: | BOSTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 02115 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6176326049 | ||||||||
| FaxNumber: | 6176325786 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/01/2006 | ||||||||
| LastUpdateDate: | 06/07/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RX0202X | 157015 | MA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Medical Oncology |
ID Information
| ID | Type | State | Issuer | Description | 2555962 | 01 | AETNA US HEALTHCARE | OTHER | 3004709 | 01 | UNITED HEALTH CARE | OTHER | 3183432 | 01 | MASSHEALTH | OTHER | 5614733 | 01 | CIGNA | OTHER | J19813 | 01 | BLUE CROSS BLUE SHIELD OF | OTHER | 14723DF | 01 | HPHC | OTHER | 413299 | 01 | TUFTS | OTHER | 63374 | 01 | FALLON COMMUNITY HEALTH P | OTHER |