Provider Demographics
NPI:1013575091
Name:JL PLASTIC SURGERY, INC.
Entity Type:Organization
Organization Name:JL PLASTIC SURGERY, INC.
Other - Org Name:JL PLASTIC SURGERY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PLASTIC SURGEON
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:H
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:617-340-2822
Mailing Address - Street 1:170 COMMONWEALTH AVE STE 112
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02116-2704
Mailing Address - Country:US
Mailing Address - Phone:617-340-2822
Mailing Address - Fax:617-340-2864
Practice Address - Street 1:170 COMMONWEALTH AVE
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02116-2704
Practice Address - Country:US
Practice Address - Phone:617-340-2822
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-04
Last Update Date:2023-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive SurgeryGroup - Single Specialty