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General NPI Number Information
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NPI Number | 1881296556
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Entity Type | Individual
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Provider Name | JAEYOUNG HAN NP
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Gender | Female
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Dates
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Enumeration Date | 11/09/2020
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Last Update Date | 05/16/2025
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Provider Practice Location Address
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Address Line | 1101 BEACON ST STE 8W
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City | BROOKLINE
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State | MA
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Zip | 02446-5587
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Country | US
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Telephone | 617-855-7288
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Fax |
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Provider Business Mailing Address
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Address Line | 43 GERRY RD
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City | CHESTNUT HILL
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State | MA
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Zip | 02467-3139
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Country | US
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Telephone | 347-334-9388
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | RN2276327
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License Number State | MA
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