Provider Demographics
NPI:1598269359
Name:SHEHAN, JENNIFER NICOLE (MD)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:NICOLE
Last Name:SHEHAN
Suffix:
Gender:F
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:960 MASSACHUSETTS AVE
Mailing Address - Street 2:FL 2
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02118-2690
Mailing Address - Country:US
Mailing Address - Phone:617-414-5405
Mailing Address - Fax:617-414-6031
Practice Address - Street 1:830 HARRISON AVENUE
Practice Address - Street 2:STE 1400
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02118
Practice Address - Country:US
Practice Address - Phone:617-638-8124
Practice Address - Fax:617-414-4953
Is Sole Proprietor?:No
Enumeration Date:2018-03-19
Last Update Date:2024-08-28
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Provider Licenses
StateLicense IDTaxonomies
MA1019730207YX0905X, 207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
No207YX0905XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngology/Facial Plastic Surgery