1265422117 NPI number — MRS. JUSTINE MCGUIRK LAMBROSCHINO LICSW

Table of content: MRS. JUSTINE MCGUIRK LAMBROSCHINO LICSW (NPI 1265422117)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1265422117 NPI number — MRS. JUSTINE MCGUIRK LAMBROSCHINO LICSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LAMBROSCHINO
Provider First Name:
JUSTINE
Provider Middle Name:
MCGUIRK
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
LICSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
LAMBROSCHINO
Provider Other First Name:
JUSTINE
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
LICSW
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1265422117
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/30/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
51 GIFFORD ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FALMOUTH
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02540-3360
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
508-317-5243
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
51 GIFFORD ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FALMOUTH
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02540-3304
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
508-317-5243
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/24/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  111885 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 002734133 . This is a "OPTUM/UBH" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: P08408 . This is a "BLUE CROSS" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 0007368924 . This is a "AETNA" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 1859544 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1137020 . This is a "NHP" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 550010006939 . This is a "PACIFICARE/HARVARDPILGRIM" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 1137020 . This is a "BEACON" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".




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