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General NPI Number Information
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NPI Number | 1194135111
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Entity Type | Individual
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Provider Name | CIARA IRENE DIMOU R.N., N.P.
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Gender | Female
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Dates
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Enumeration Date | 04/29/2014
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Last Update Date | 03/12/2018
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Provider Practice Location Address
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Address Line | 41 MALL ROAD LAHEY HOSPITAL AND MEDICAL CENTER
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City | BURLINGTON
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State | MA
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Zip | 01805-0001
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Country | US
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Telephone | 781-744-7000
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Fax | 781-744-5351
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Provider Business Mailing Address
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Address Line | 421 MERRIMACK ST SUITE 201
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City | METHUEN
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State | MA
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Zip | 01844-5864
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Country | US
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Telephone | 978-725-4822
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Fax |
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | RN2284486
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | RN2284486
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License Number State | MA
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