| Mr Jack Jienan Fang, MD | |
|
6265 Saunders St Apt 5g, Rego Park, NY 11374-1576 | |
| (347) 205-7909 | |
| Not Available |
| Full Name | Mr Jack Jienan Fang |
|---|---|
| Gender | Male |
| Speciality | Hospitalist |
| Experience | 14 Years |
| Location | 6265 Saunders St Apt 5g, Rego Park, New York |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083904080 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 260808 (Massachusetts) | Secondary |
| 208M00000X | Hospitalist | 260808 (Massachusetts) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Lahey Hospital & Medical Center, Burlington | Burlington, MA | Hospital |
| Northeast Hospital Corporation | Beverly, MA | Hospital |
| Winchester Hospital | Winchester, MA | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Lahey Clinic Inc | 2264336528 | 1268 |
| Winchester Lahey Inpatient Specialists Pllc | 6608150149 | 30 |
| Lowell General Inpatient Specialists Pllc | 8729371380 | 62 |
| Entity Name | Lahey Clinic Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1538194980 PECOS PAC ID: 2264336528 Enrollment ID: O20031120000097 |
| Entity Name | Lahey Clinic Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1063447316 PECOS PAC ID: 2264336528 Enrollment ID: O20040629001269 |
| Entity Name | Lowell General Inpatient Specialists Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1649626391 PECOS PAC ID: 8729371380 Enrollment ID: O20160720001673 |
| Entity Name | Winchester Lahey Inpatient Specialists Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1144770629 PECOS PAC ID: 6608150149 Enrollment ID: O20170301002194 |
| Mailing Address | Practice Location Address |
|---|---|
| Mr Jack Jienan Fang, MD 4323 Colden St Apt 19m, Flushing, NY 11355-5926 Ph: (347) 205-7909 | Mr Jack Jienan Fang, MD 6265 Saunders St Apt 5g, Rego Park, NY 11374-1576 Ph: (347) 205-7909 |