Provider Demographics
NPI:1316384431
Name:CHAMBERS, JACQUELYN (MD)
Entity type:Individual
Prefix:
First Name:JACQUELYN
Middle Name:
Last Name:CHAMBERS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:74 LOOMIS ST
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01730-2248
Mailing Address - Country:US
Mailing Address - Phone:781-274-2900
Mailing Address - Fax:781-275-0688
Practice Address - Street 1:55 FRUIT ST
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-2621
Practice Address - Country:US
Practice Address - Phone:781-674-2900
Practice Address - Fax:781-275-0688
Is Sole Proprietor?:No
Enumeration Date:2013-05-30
Last Update Date:2025-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA266003208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics