Healthcare Provider Details

I. General information

NPI: 1811978711
Provider Name (Legal Business Name): LAWRENCE JAY EPSTEIN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/08/2005
Last Update Date: 11/07/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1153 CENTRE ST STE 5K
BOSTON MA
02130-3446
US

IV. Provider business mailing address

1153 CENTRE ST STE 5K
BOSTON MA
02130-3446
US

V. Phone/Fax

Practice location:
  • Phone: 617-983-7280
  • Fax: 617-983-7288
Mailing address:
  • Phone: 617-983-7280
  • Fax: 617-983-7288

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number82041
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License Number82041
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: