Provider Demographics
NPI:1386083723
Name:SHEN, JENNIFER I HSUAN (MD)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:I HSUAN
Last Name:SHEN
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 1:1500 LEXINGTON AVE APT 16D
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10029-7357
Mailing Address - Country:US
Mailing Address - Phone:716-548-7370
Mailing Address - Fax:
Practice Address - Street 1:2375 MONTECITO DR
Practice Address - Street 2:
Practice Address - City:SAN MARINO
Practice Address - State:CA
Practice Address - Zip Code:91108-1207
Practice Address - Country:US
Practice Address - Phone:716-548-7370
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-19
Last Update Date:2013-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA0207LH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LH0002XAllopathic & Osteopathic PhysiciansAnesthesiologyHospice and Palliative Medicine