Provider Demographics
NPI:1306990940
Name:LAILA ATTAR, M.D. LLC
Entity type:Organization
Organization Name:LAILA ATTAR, M.D. LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LAILA
Authorized Official - Middle Name:
Authorized Official - Last Name:ATTAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:978-433-0517
Mailing Address - Street 1:66 HOLLIS ST
Mailing Address - Street 2:P.O. BOX 1369
Mailing Address - City:PEPPERELL
Mailing Address - State:MA
Mailing Address - Zip Code:01463-1432
Mailing Address - Country:US
Mailing Address - Phone:978-433-0517
Mailing Address - Fax:978-433-8037
Practice Address - Street 1:66 HOLLIS ST
Practice Address - Street 2:
Practice Address - City:PEPPERELL
Practice Address - State:MA
Practice Address - Zip Code:01463-1432
Practice Address - Country:US
Practice Address - Phone:978-433-0517
Practice Address - Fax:978-433-8037
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA218810207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA9717960Medicaid
MA80790OtherFALLON
MAM18340OtherBCBS OF MA
MA467256OtherTUFTS
MA467256OtherTUFTS
MA9717960Medicaid