Healthcare Provider Details

I. General information

NPI: 1548634637
Provider Name (Legal Business Name): LASELL COLLEGE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/30/2015
Last Update Date: 11/30/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1844 COMMONWEALTH AVE
AUBURNDALE MA
02466-2709
US

IV. Provider business mailing address

1844 COMMONWEALTH AVE
AUBURNDALE MA
02466-2709
US

V. Phone/Fax

Practice location:
  • Phone: 617-243-2131
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: CRISTINA HAVERTY
Title or Position: DEPARTMENT CHAIR
Credential:
Phone: 617-243-2131