Northeast Physician Practice

NPI #1841228632 in Lynn, Massachusetts

Provider Information

NPI Number: 1841228632
Entity Type: Organization
Organization Name: Northeast Physician Practice
Primary Specialty: Specialist
Enumeration Date: Jun 29, 2006
Last Updated: Aug 22, 2020

Practice Location

Address: 225 BOSTON ST
Address 2: SUITE 205
City: Lynn
State: Massachusetts
ZIP Code: 01904-3137
Phone: (781) 595-4544

Authorized Official

Name: KIM ROUILLARD
Title: CREDENTIALING MANAGER
Phone: (978) 818-6110

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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