Mandeville, Jessica A
Mandeville, Jessica A is an individual health care provider with primary practice located at 41 Mall Rd Lahey Clinic, Burlington MA 01805-0001. She recently has only one registered license in Allopathic & Osteopathic Physicians / Urology, which is considered as her primary health care specialty. Mandeville, Jessica A can be contacted via phone (781) 744-2511.Contact Information
Primary practice address
41 Mall Rd Lahey Clinic
Burlington MA 01805-0001
Phone: (781) 744-2511
Fax: (781) 744-5429
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Urology | 208800000X | 251318 | Massachusetts |
Profile Details
| NPI number | 1396916045 |
|---|---|
| LBN Legal business name | Mandeville, Jessica A |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 20th, 2008 |
| Last updated | Dec 18th, 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1396916045 | NPPES |
| Massachusetts | MEDICAID | 110092756A |
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Maclachlan, Lara
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