Provider Demographics
NPI:1558301663
Name:LAMBERT, NYLA ANN (OD)
Entity type:Individual
Prefix:DR
First Name:NYLA
Middle Name:ANN
Last Name:LAMBERT
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:939 SALEM ST
Mailing Address - Street 2:SUITE 7
Mailing Address - City:GROVELAND
Mailing Address - State:MA
Mailing Address - Zip Code:01834-1565
Mailing Address - Country:US
Mailing Address - Phone:978-374-8991
Mailing Address - Fax:978-373-7852
Practice Address - Street 1:939 SALEM ST
Practice Address - Street 2:SUITE 7
Practice Address - City:GROVELAND
Practice Address - State:MA
Practice Address - Zip Code:01834-1565
Practice Address - Country:US
Practice Address - Phone:978-374-8991
Practice Address - Fax:978-373-7852
Is Sole Proprietor?:No
Enumeration Date:2006-06-07
Last Update Date:2015-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4306152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAW16356OtherBCBS
MA329592Medicaid
MAAA12124OtherHARVARD PILGRIM
MAU96073Medicare UPIN
MAW17482Medicare ID - Type Unspecified