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General NPI Number Information
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NPI Number | 1184644221
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Entity Type | Individual
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Provider Name | TIMOTHY LAHEY MD MMSC
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Gender | Male
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Dates
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Enumeration Date | 07/20/2006
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Last Update Date | 09/07/2018
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Provider Practice Location Address
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Address Line | 111 COLCHESTER AVE
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City | BURLINGTON
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State | VT
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Zip | 05401-1473
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Country | US
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Telephone | 802-847-4594
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Fax |
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Provider Business Mailing Address
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Address Line | 1 MEDICAL CENTER DR
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City | LEBANON
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State | NH
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Zip | 03756-1000
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Country | US
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Telephone | 603-650-8840
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Fax | 603-650-6199
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number | 042.0014159
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License Number State | VT
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