Healthcare Provider Details

I. General information

NPI: 1699006601
Provider Name (Legal Business Name): LYNN MARIE ABBOTT RD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/15/2010
Last Update Date: 01/15/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

ONE JOSLIN PLACE JOSLIN DIABETES CENTER AND JOSLIN CLINIC
BOSTON MA
02215
US

IV. Provider business mailing address

18 STRATHAM LN
STRATHAM NH
03885-2124
US

V. Phone/Fax

Practice location:
  • Phone: 617-732-2400
  • Fax:
Mailing address:
  • Phone: 603-436-8755
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number28
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: