Healthcare Provider Details

I. General information

NPI: 1689682379
Provider Name (Legal Business Name): LUCY W. ARNOLD MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/04/2006
Last Update Date: 11/17/2020
Certification Date: 11/17/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

133 BROOKLINE AVE
BOSTON MA
02215-3904
US

IV. Provider business mailing address

133 BROOKLINE AVE FL 9
BOSTON MA
02215-3904
US

V. Phone/Fax

Practice location:
  • Phone: 617-421-6050
  • Fax: 617-421-6083
Mailing address:
  • Phone: 617-421-6050
  • Fax: 617-421-6083

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0202X
TaxonomyPediatric Cardiology Physician
License Number57836
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: