Healthcare Provider Details

I. General information

NPI: 1538033493
Provider Name (Legal Business Name): LAMAR ABU GHOSH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/02/2025
Last Update Date: 10/02/2025
Certification Date: 10/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 BIRCH HILL RD
SALEM NH
03079-3479
US

IV. Provider business mailing address

20 BIRCH HILL RD
SALEM NH
03079-3479
US

V. Phone/Fax

Practice location:
  • Phone: 978-955-8000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code146N00000X
TaxonomyBasic Emergency Medical Technician
License Number7221-5065-7455
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: