1265428411 NPI number — EMILY G LOWRY M.D.

Table of content: EMILY G LOWRY M.D. (NPI 1265428411)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1265428411 NPI number — EMILY G LOWRY M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LOWRY
Provider First Name:
EMILY
Provider Middle Name:
G
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
COLE
Provider Other First Name:
EMILY
Provider Other Middle Name:
LOWRY
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1265428411
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9 GLEN AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ARLINGTON
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02474-1233
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
781-641-0791
Provider Business Mailing Address Fax Number:
781-646-5910

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2 REHABILITATION WAY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WOBURN
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
01801-6003
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
781-935-5050
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/23/2005

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: 207R00000X , with the licence number:  46257 , 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: 0116807 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".