Provider Demographics
NPI:1679922793
Name:LEE, JENNIFER WANG (MD)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:WANG
Last Name:LEE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:526 MAIN ST STE 302
Mailing Address - Street 2:
Mailing Address - City:ACTON
Mailing Address - State:MA
Mailing Address - Zip Code:01720-3301
Mailing Address - Country:US
Mailing Address - Phone:978-371-7010
Mailing Address - Fax:789-371-0522
Practice Address - Street 1:128 CARNEGIE ROW STE 202
Practice Address - Street 2:
Practice Address - City:NORWOOD
Practice Address - State:MA
Practice Address - Zip Code:02062-5162
Practice Address - Country:US
Practice Address - Phone:781-762-5858
Practice Address - Fax:781-617-6202
Is Sole Proprietor?:No
Enumeration Date:2016-06-09
Last Update Date:2023-07-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA282881207N00000X, 207ND0101X
RIMD18690207ND0101X, 207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic Surgery
No207N00000XAllopathic & Osteopathic PhysiciansDermatology