Provider Demographics
NPI:1063670156
Name:CHIANG, JENNY SHIH-JEN (MD)
Entity Type:Individual
Prefix:DR
First Name:JENNY
Middle Name:SHIH-JEN
Last Name:CHIANG
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 1:34 HAVERHILL ST
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:MA
Mailing Address - Zip Code:01841-2884
Mailing Address - Country:US
Mailing Address - Phone:978-686-0090
Mailing Address - Fax:978-681-5963
Practice Address - Street 1:34 HAVERHILL ST
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:MA
Practice Address - Zip Code:01841-2884
Practice Address - Country:US
Practice Address - Phone:978-686-0090
Practice Address - Fax:978-681-5963
Is Sole Proprietor?:No
Enumeration Date:2008-05-27
Last Update Date:2014-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT192886207Q00000X
MA255554207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine