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NPI Code Detail

MEDICARE: DR. JIN BYUNG BYUNG CHAE M.D.

MEDICARE: DR. JIN BYUNG BYUNG CHAE M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine Physician235359MA

General Provider Information

NPI Number : 1477713121
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JIN BYUNG BYUNG CHAE M.D.
Provider Business Mailing Address
First Line : 19 HANCOCK ST
Second Line :
City : LEXINGTON
State : MA
Zip : 02420-3443
Country : US
Telephone Number : 781-879-9917
Fax Number :
Provider Business Practice Location Address
First Line : 70 FULTON ST
Second Line :
City : BOSTON
State : MA
Zip : 02109-1402
Country : US
Telephone Number : 617-876-4344
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/16/2008
Last Update Date : 01/19/2021

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