Healthcare Provider Details

I. General information

NPI: 1487054862
Provider Name (Legal Business Name): MRS. ALBA KUILAN LAMBOY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/04/2014
Last Update Date: 09/04/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21 PERRON WAY
LOWELL MA
01854-4912
US

IV. Provider business mailing address

21 PERRON WAY
LOWELL MASSACHUSETTS (MA)
01854
UM

V. Phone/Fax

Practice location:
  • Phone: 978-387-9806
  • Fax:
Mailing address:
  • Phone: 978-387-9806
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: