Provider Demographics
NPI:1700027000
Name:LIEGEL, JESSICA JAYNE (MD)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:JAYNE
Last Name:LIEGEL
Suffix:
Gender:F
Credentials:MD
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:330 BROOKLINE AVE
Mailing Address - Street 2:SHAPIRO 913
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02215-5400
Mailing Address - Country:US
Mailing Address - Phone:617-667-2100
Mailing Address - Fax:617-975-5665
Practice Address - Street 1:330 BROOKLINE AVE
Practice Address - Street 2:SHAPIRO 913
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02215-5400
Practice Address - Country:US
Practice Address - Phone:617-667-2100
Practice Address - Fax:617-975-5665
Is Sole Proprietor?:No
Enumeration Date:2009-03-16
Last Update Date:2019-12-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA260569207RH0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0000XAllopathic & Osteopathic PhysiciansInternal MedicineHematology