Healthcare Provider Details

I. General information

NPI: 1215021407
Provider Name (Legal Business Name): MARTIN JAY LACHMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17 93 RD ST MONADNOCK FAMILY SERVICES
KEENE NH
03431-3773
US

IV. Provider business mailing address

31 ROBBINS ROAD
KEENE NH
03431-2880
US

V. Phone/Fax

Practice location:
  • Phone: 603-357-5270
  • Fax: 603-357-6875
Mailing address:
  • Phone: 603-352-2009
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number10843
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: