Provider Demographics
NPI:1538126834
Name:LEE, JENNIFER HEIJUNG (MD)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:HEIJUNG
Last Name:LEE
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 1:850 BOYLSTON STREET
Mailing Address - Street 2:BRIGHAM AND WOMEN'S PHYSICIAN GROUP
Mailing Address - City:CHESTNUT HILL
Mailing Address - State:MA
Mailing Address - Zip Code:02467
Mailing Address - Country:US
Mailing Address - Phone:617-732-5773
Mailing Address - Fax:
Practice Address - Street 1:850 BOYLSTON STREET
Practice Address - Street 2:BRIGHAM AND WOMEN'S PHYSICIAN GROUP
Practice Address - City:CHESTNUT HILL
Practice Address - State:MA
Practice Address - Zip Code:02467
Practice Address - Country:US
Practice Address - Phone:617-732-5500
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA215914207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine