Provider Demographics
NPI:1871796185
Name:TOWN OF LYNNFIELD
Entity type:Organization
Organization Name:TOWN OF LYNNFIELD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HEALTH AGENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:J
Authorized Official - Last Name:NUGENT
Authorized Official - Suffix:
Authorized Official - Credentials:RSCHO
Authorized Official - Phone:781-334-2032
Mailing Address - Street 1:55 SUMMER STREET
Mailing Address - Street 2:
Mailing Address - City:LYNNFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01940
Mailing Address - Country:US
Mailing Address - Phone:781-334-9481
Mailing Address - Fax:781-334-5829
Practice Address - Street 1:55 SUMMER STREET
Practice Address - Street 2:
Practice Address - City:LYNNFIELD
Practice Address - State:MA
Practice Address - Zip Code:01940
Practice Address - Country:US
Practice Address - Phone:781-334-9481
Practice Address - Fax:781-334-5829
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-06
Last Update Date:2008-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAY11101Medicare PIN