Provider Demographics
NPI:1528320975
Name:LIN, JESSICA JIYEONG (MD)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:JIYEONG
Last Name:LIN
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 1:32 FRUIT ST
Mailing Address - Street 2:YAWKEY 7B
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02114-2620
Mailing Address - Country:US
Mailing Address - Phone:617-724-4000
Mailing Address - Fax:
Practice Address - Street 1:32 FRUIT ST
Practice Address - Street 2:YAWKEY 7B
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-2620
Practice Address - Country:US
Practice Address - Phone:617-724-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-12
Last Update Date:2018-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA251345207R00000X
MA258963207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine