Healthcare Provider Details

I. General information

NPI: 1568884559
Provider Name (Legal Business Name): IQRA JAVEED M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/10/2014
Last Update Date: 06/26/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

LAHEY HOSPITAL & MEDICAL CENTER 41 MALL ROAD
BURLINGTON MA
01805
US

IV. Provider business mailing address

LAHEY HOSPITAL & MEDICAL CENTER 41 MALL ROAD
BURLINGTON MA
01805-0001
US

V. Phone/Fax

Practice location:
  • Phone: 781-744-2088
  • Fax: 781-744-5348
Mailing address:
  • Phone: 781-744-2088
  • Fax: 781-744-5348

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number267890
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: