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General NPI Number Information
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NPI Number | 1043926686
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Entity Type | Organization
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Legal Business Name | HARBOR INTERVENTIONAL PAIN CENTER, LLC
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Dates
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Enumeration Date | 01/26/2023
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Last Update Date | 04/01/2025
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Provider Practice Location Address
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Address Line | 291 SHATTUCK WAY STE 2
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City | NEWINGTON
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State | NH
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Zip | 03801-7869
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Country | US
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Telephone | 603-294-9190
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Fax | 603-380-7967
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Provider Business Mailing Address
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Address Line | 291 SHATTUCK WAY STE 2
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City | NEWINGTON
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State | NH
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Zip | 03801-7869
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Country | US
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Telephone | 603-294-9190
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Fax | 603-380-7967
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Authorized Official
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Title or Position | OWNER/PRINCIPLE
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Name | TIMOTHY L LACY
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Credential | MD
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Telephone | 603-294-9190
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number |
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License Number State |
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