Provider Demographics
NPI:1902035280
Name:SUN, JENNY YING XIN (MD)
Entity Type:Individual
Prefix:
First Name:JENNY
Middle Name:YING XIN
Last Name:SUN
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:1250 HANCOCK ST
Mailing Address - Street 2:INTERNAL MEDICINE
Mailing Address - City:QUINCY
Mailing Address - State:MA
Mailing Address - Zip Code:02169-4339
Mailing Address - Country:US
Mailing Address - Phone:617-774-0840
Mailing Address - Fax:617-774-0882
Practice Address - Street 1:1250 HANCOCK ST
Practice Address - Street 2:INTERNAL MEDICINE
Practice Address - City:QUINCY
Practice Address - State:MA
Practice Address - Zip Code:02169-4339
Practice Address - Country:US
Practice Address - Phone:617-774-0840
Practice Address - Fax:617-774-0882
Is Sole Proprietor?:No
Enumeration Date:2009-07-08
Last Update Date:2013-11-18
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Provider Licenses
StateLicense IDTaxonomies
MA230202207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA003077601Medicare PIN