MEDICARE: DR. MARY ELIZABETH LYONS-HUNTER PSYD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103T00000X	Psychologist	7904	MA

General Provider Information

NPI Number	:	1538140363
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARY ELIZABETH LYONS-HUNTER PSYD

Provider Business Mailing Address
First Line	:	PO BOX 9142
Second Line	:	MASS GENERAL PHYSICIAN ORGANIZATION
City	:	CHARLESTOWN
State	:	MA
Zip	:	02129-9142
Country	:	US
Telephone Number	:	617-724-0287
Fax Number	:	617-726-2894

Provider Business Practice Location Address
First Line	:	151 EVERETT AVE
Second Line	:	MGH CHELSEA HEALTHCARE CTR
City	:	CHELSEA
State	:	MA
Zip	:	02150-1812
Country	:	US
Telephone Number	:	617-889-8515
Fax Number	:	617-889-8509

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/09/2005
Last Update Date	:	07/08/2007

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