Provider Demographics
NPI:1871580571
Name:CHAI, JESSIE LYNN (MD)
Entity type:Individual
Prefix:
First Name:JESSIE
Middle Name:LYNN
Last Name:CHAI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:75 FRANCIS ST
Mailing Address - Street 2:RADIOLOGY, BRIGHAM AND WOMEN'S HOSPITAL
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02115-6110
Mailing Address - Country:US
Mailing Address - Phone:617-732-9801
Mailing Address - Fax:617-732-8064
Practice Address - Street 1:75 FRANCIS ST
Practice Address - Street 2:RADIOLOGY, BRIGHAM AND WOMEN'S HOSPITAL
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115-6110
Practice Address - Country:US
Practice Address - Phone:617-732-9801
Practice Address - Fax:617-732-8064
Is Sole Proprietor?:No
Enumeration Date:2005-09-29
Last Update Date:2012-08-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA793042085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAJ16226OtherBLUE CROSS/BLUE SHIELD
MA079304OtherTUFTS HEALTH CARE
MA3142604Medicaid
MAJ16226OtherBLUE CROSS/BLUE SHIELD
G08976Medicare UPIN