Provider Demographics
NPI:1427284249
Name:IACOPUCCI, LORRAINE T (MED)
Entity type:Individual
Prefix:MS
First Name:LORRAINE
Middle Name:T
Last Name:IACOPUCCI
Suffix:
Gender:F
Credentials:MED
Other - Prefix:MS
Other - First Name:LORRAINE
Other - Middle Name:T
Other - Last Name:IACOPUCCI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MED
Mailing Address - Street 1:2067 MASSACHUSETTS AVE
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02140-1340
Mailing Address - Country:US
Mailing Address - Phone:617-575-5523
Mailing Address - Fax:
Practice Address - Street 1:2067 MASSACHUSETTS AVE.
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02140
Practice Address - Country:US
Practice Address - Phone:617-575-5523
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-08
Last Update Date:2016-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator