Provider Demographics
NPI:1679185722
Name:CHAE INTERNAL MEDICINE LLC
Entity type:Organization
Organization Name:CHAE INTERNAL MEDICINE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JIN
Authorized Official - Middle Name:BYUNG
Authorized Official - Last Name:CHAE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:781-879-9917
Mailing Address - Street 1:19 HANCOCK ST
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02420-3443
Mailing Address - Country:US
Mailing Address - Phone:781-879-9917
Mailing Address - Fax:
Practice Address - Street 1:70 FULTON ST
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02109-1402
Practice Address - Country:US
Practice Address - Phone:617-876-4344
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-20
Last Update Date:2020-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty