Healthcare Provider Details

I. General information

NPI: 1548358930
Provider Name (Legal Business Name): LAUREN M. HANDELMAN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/11/2006
Last Update Date: 08/03/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 CENTRE STREET SUITE 104
NEWTON MA
02459
US

IV. Provider business mailing address

79 ERDMAN WAY SUITE 101
LEOMINSTER MA
01453
US

V. Phone/Fax

Practice location:
  • Phone: 617-765-0228
  • Fax: 617-340-6466
Mailing address:
  • Phone: 978-537-4805
  • Fax: 978-537-2185

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number156215
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number156215
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: