Healthcare Provider Details

I. General information

NPI: 1730573957
Provider Name (Legal Business Name): BRIGITTA LAMB M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2015
Last Update Date: 07/22/2024
Certification Date: 07/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 OCEAN AVE
REVERE MA
02151-3675
US

IV. Provider business mailing address

300 OCEAN AVE
REVERE MA
02151-3675
US

V. Phone/Fax

Practice location:
  • Phone: 781-485-6100
  • Fax:
Mailing address:
  • Phone: 781-485-6100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberA144267
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number278998
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: