Healthcare Provider Details

I. General information

NPI: 1316929342
Provider Name (Legal Business Name): JENNIFER F TSENG M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/16/2005
Last Update Date: 03/22/2021
Certification Date: 03/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

830 HARRISON AVENUE MOAKLEY, SUITE 3400
BOSTON MA
02118
US

IV. Provider business mailing address

801 ALBANY ST FL GROUND
BOSTON MA
02119-2560
US

V. Phone/Fax

Practice location:
  • Phone: 617-414-8060
  • Fax: 617-414-8457
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number157375
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code2086X0206X
TaxonomySurgical Oncology Physician
License Number157375
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: