Provider Demographics
NPI:1124458120
Name:LUNG SPECIALISTS OF MERRIMACK
Entity type:Organization
Organization Name:LUNG SPECIALISTS OF MERRIMACK
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:DENIS
Authorized Official - Middle Name:Y
Authorized Official - Last Name:LIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:978-934-9220
Mailing Address - Street 1:275 VARNUM AVE
Mailing Address - Street 2:SUITE 203
Mailing Address - City:LOWELL
Mailing Address - State:MA
Mailing Address - Zip Code:01854-2141
Mailing Address - Country:US
Mailing Address - Phone:978-934-9220
Mailing Address - Fax:978-453-7771
Practice Address - Street 1:275 VARNUM AVE
Practice Address - Street 2:SUITE 203
Practice Address - City:LOWELL
Practice Address - State:MA
Practice Address - Zip Code:01854-2141
Practice Address - Country:US
Practice Address - Phone:978-934-9220
Practice Address - Fax:978-453-7771
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LUNG SPECIALISTS OF MERRIMACK
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-11-13
Last Update Date:2015-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA71291207RS0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep MedicineGroup - Single Specialty