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General NPI Number Information
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NPI Number | 1972802536
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Entity Type | Individual
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Provider Name | JUFANG SHI PHD RPH
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Gender | Female
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Dates
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Enumeration Date | 03/22/2011
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Last Update Date | 03/22/2011
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Provider Practice Location Address
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Address Line | 15 NEW ENGLAND EXECUTIVE PARK
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City | BURLINGTON
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State | MA
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Zip | 01803-5202
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Country | US
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Telephone | 781-791-5066
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Fax | 781-402-0284
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Provider Business Mailing Address
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Address Line | 3 PIPER RD 3 PIPER ROAD
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City | LEXINGTON
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State | MA
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Zip | 02421-8106
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Country | US
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Telephone | 781-608-8128
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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 | 1835G0303X
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Taxonomy Name | Geriatric
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License Number | 27349
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License Number State | MA
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