Geoghegan, Lawrence T

Geoghegan, Lawrence T is an individual health care provider with primary practice located at 77 Massachusetts Ave Mit Medical Department E23-300, Cambridge MA 02139-4301. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Geoghegan, Lawrence T can be contacted via phone (617) 253-4988.

Contact Information

Primary practice address
77 Massachusetts Ave Mit Medical Department E23-300 Cambridge MA 02139-4301
Phone: (617) 253-4988
Fax: (617) 253-7265
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X 30208 Massachusetts

Profile Details

NPI number 1477543031
LBN Legal business name Geoghegan, Lawrence T
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 25th, 2005
Last updated Dec 28th, 2012 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1477543031 NPPES
Massachusetts MEDICAID 0175161
Massachusetts Other B33229
Massachusetts Other LAM12968
Massachusetts Other 030208

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