Provider Demographics
NPI:1609885417
Name:JONAS, MAUREEN M (MD)
Entity type:Individual
Prefix:
First Name:MAUREEN
Middle Name:M
Last Name:JONAS
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:300 LONGWOOD AVE
Mailing Address - Street 2:CHILDREN'S HOSPITAL DIVISION OF GASTROENTEROLOGY
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02115-5724
Mailing Address - Country:US
Mailing Address - Phone:516-355-7964
Mailing Address - Fax:
Practice Address - Street 1:300 LONGWOOD AVE
Practice Address - Street 2:CHILDREN'S HOSPITAL DIVISION OF GASTROENTEROLOGY
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115-5724
Practice Address - Country:US
Practice Address - Phone:516-355-7964
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-08
Last Update Date:2015-08-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA474512080P0206X, 2080T0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080T0004XAllopathic & Osteopathic PhysiciansPediatricsPediatric Transplant Hepatology
No2080P0206XAllopathic & Osteopathic PhysiciansPediatricsPediatric Gastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0170798Medicaid
E05798Medicare ID - Type Unspecified
MA0170798Medicaid