Provider Demographics
NPI:1174015960
Name:SHEN, JUN (PHD, FACMG)
Entity Type:Individual
Prefix:DR
First Name:JUN
Middle Name:
Last Name:SHEN
Suffix:
Gender:F
Credentials:PHD, FACMG
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:221 LONGWOOD AVE # 422B
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02115-5817
Mailing Address - Country:US
Mailing Address - Phone:617-732-5143
Mailing Address - Fax:617-525-4533
Practice Address - Street 1:221 LONGWOOD AVE # 422B
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115-5817
Practice Address - Country:US
Practice Address - Phone:617-732-5143
Practice Address - Fax:617-525-4533
Is Sole Proprietor?:No
Enumeration Date:2018-06-06
Last Update Date:2018-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZG1000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherGeneticist, Medical (PhD)