Provider Demographics
NPI:1629143730
Name:JANEWAY, ELEANOR A (MD)
Entity type:Individual
Prefix:
First Name:ELEANOR
Middle Name:A
Last Name:JANEWAY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:841 CENTRAL ST STE 101
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:NH
Mailing Address - Zip Code:03235-2053
Mailing Address - Country:US
Mailing Address - Phone:603-934-1464
Mailing Address - Fax:
Practice Address - Street 1:841 CENTRAL ST STE 101
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:NH
Practice Address - Zip Code:03235
Practice Address - Country:US
Practice Address - Phone:603-934-1464
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-22
Last Update Date:2018-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA150774207R00000X
NH18668207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3170951Medicaid
MAJ18108OtherBCBS MA
G62000Medicare UPIN
MAMX9547Medicare PIN