Healthcare Provider Details

I. General information

NPI: 1902322597
Provider Name (Legal Business Name): LP HEALTH NETWORK LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/16/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

51 SAWYER RD STE 340
WALTHAM MA
02453-3448
US

IV. Provider business mailing address

51 SAWYER RD STE 340
WALTHAM MA
02453-3448
US

V. Phone/Fax

Practice location:
  • Phone: 800-525-7279
  • Fax:
Mailing address:
  • Phone: 800-525-7279
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License Number
License Number State

VIII. Authorized Official

Name: BRYAN KENDALL
Title or Position: SECRETARY
Credential:
Phone: 781-810-2430