Healthcare Provider Details

I. General information

NPI: 1003961988
Provider Name (Legal Business Name): LILLIAN RICH M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/24/2007
Last Update Date: 09/09/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

60 HOSPITAL RD WACHUSETT EMERGENCY PHYSICIANS
LEOMINSTER MA
01453-2205
US

IV. Provider business mailing address

60 HOSPITAL RD WACHUSETT EMERGENCY PHYSICIANS
LEOMINSTER MA
01453-2205
US

V. Phone/Fax

Practice location:
  • Phone: 978-466-2994
  • Fax: 978-466-2993
Mailing address:
  • Phone: 978-466-2994
  • Fax: 978-466-2993

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number235627
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: