Basic Information
| Provider Information | |||||||||
| NPI: | 1194163469 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | FAIG | ||||||||
| FirstName: | JENNIFER | ||||||||
| MiddleName: | ANNE | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 101 COLUMBIAN ST | ||||||||
| Address2: | |||||||||
| City: | WEYMOUTH | ||||||||
| State: | MA | ||||||||
| PostalCode: | 021901601 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7816245000 | ||||||||
| FaxNumber: | 7816244840 | ||||||||
| Practice Location | |||||||||
| Address1: | 101 COLUMBIAN ST | ||||||||
| Address2: | |||||||||
| City: | WEYMOUTH | ||||||||
| State: | MA | ||||||||
| PostalCode: | 02190 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7816245000 | ||||||||
| FaxNumber: | 7816244840 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/10/2013 | ||||||||
| LastUpdateDate: | 05/08/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 256028 | MA | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207RH0003X | 26631 | MA | N | Allopathic & Osteopathic Physicians | Internal Medicine | Hematology & Oncology | 207RX0202X | 26631 | MA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Medical Oncology |
No ID Information.