Healthcare Provider Details

I. General information

NPI: 1457441768
Provider Name (Legal Business Name): NATALYA LIPCHIN NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/15/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 WASHINGTON ST BLUE BILDING, SUITE 420
NEWTON MA
02462-1650
US

IV. Provider business mailing address

57 SACO ST
NEWTON MA
02464-1319
US

V. Phone/Fax

Practice location:
  • Phone: 617-630-9823
  • Fax: 617-630-4481
Mailing address:
  • Phone: 617-796-9744
  • Fax: 617-796-9744

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License Number237449
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: