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General NPI Number Information
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NPI Number | 1457773541
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Entity Type | Organization
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Legal Business Name | LIANNE INC
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Dates
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Enumeration Date | 01/09/2014
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Last Update Date | 11/06/2015
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Provider Practice Location Address
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Address Line | 200 LINCOLN ST
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City | WORCESTER
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State | MA
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Zip | 01605-2528
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Country | US
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Telephone | 508-755-1222
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Fax | 855-999-9140
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Provider Business Mailing Address
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Address Line | 21 COLONIAL DR
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City | SHREWSBURY
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State | MA
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Zip | 01545-1522
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Country | US
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Telephone | 508-755-1222
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Fax | 855-999-9140
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | MOHAMMAD ALHABBAL
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Credential | MD
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Telephone | 508-414-0200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 229350
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License Number State | MA
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