Healthcare Provider Details

I. General information

NPI: 1356569735
Provider Name (Legal Business Name): LOWER FALLS PEDIATRICS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/23/2007
Last Update Date: 02/27/2023
Certification Date: 01/09/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

65 WALNUT ST SUITE 310
WELLESLEY HILLS MA
02481-2118
US

IV. Provider business mailing address

65 WALNUT ST SUITE 310
WELLESLEY HILLS MA
02481-2118
US

V. Phone/Fax

Practice location:
  • Phone: 781-772-1527
  • Fax: 781-772-1497
Mailing address:
  • Phone: 781-772-1527
  • Fax: 781-772-1497

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: LORI GARA-MATTHEWS
Title or Position: PRESIDENT
Credential: MD
Phone: 781-772-1527