Individual
JENNIFER CHASE BRODER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
41 MALL RD, LAHEY CLINIC, BURLINGTON, MA 01805-0001
(781) 744-8000
Mailing address
41 MALL RD, LAHEY CLINIC, BURLINGTON, MA 01805-0001
(781) 744-8000
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
243729
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1100922341A
—
MA
Enumeration date
02/27/2007
Last updated
04/23/2013
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