Thayer, Lisa A

Thayer, Lisa A is an individual health care provider with primary practice located at 485 Arsenal St , Watertown MA 02472-5091. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Thayer, Lisa A can be contacted via phone (617) 972-5570.

Contact Information

Primary practice address
485 Arsenal St Watertown MA 02472-5091
Phone: (617) 972-5570
Fax: (617) 972-5593
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 155172 Massachusetts

Profile Details

NPI number 1073593299
LBN Legal business name Thayer, Lisa A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 23rd, 2006
Last updated Mar 8th, 2021 - about 3 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 1073593299 NPPES
Massachusetts Other 0015185 NEIGHBORHOOD HEALTH
Massachusetts MEDICAID 3189732 NEIGHBORHOOD HEALTH
Massachusetts Other J19137 NEIGHBORHOOD HEALTH
Massachusetts Other PP820 NEIGHBORHOOD HEALTH
Massachusetts Other 155172 NEIGHBORHOOD HEALTH

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