Healthcare Provider Details

I. General information

NPI: 1508545658
Provider Name (Legal Business Name): EMILY R LAWLER PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/17/2023
Last Update Date: 09/13/2023
Certification Date: 09/12/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55 FRUIT STREET WHITE 1
BOSTON MA
02114-2696
US

IV. Provider business mailing address

19 WINCHESTER ST APT 506
BROOKLINE MA
02446-2741
US

V. Phone/Fax

Practice location:
  • Phone: 410-061-7724
  • Fax: 617-726-7415
Mailing address:
  • Phone: 978-382-0274
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: