MEDICARE: PSYCHIATRIC ASSOCIATES OF LYNN

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	261QM0850X	Adult Mental Health Clinic/Center	210779	MA

General Provider Information

NPI Number	:	1740261437
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PSYCHIATRIC ASSOCIATES OF LYNN

Provider Business Mailing Address
First Line	:	350 REVERE BEACH BLVRD APT.# 9-10P
Second Line	:
City	:	REVERE
State	:	MA
Zip	:	02151-4866
Country	:	US
Telephone Number	:	781-286-5619
Fax Number	:

Provider Business Practice Location Address
First Line	:	350 REVERE BEACH BLVD
Second Line	:
City	:	REVERE
State	:	MA
Zip	:	02151-4866
Country	:	US
Telephone Number	:	781-286-5619
Fax Number	:

Authorized Official
Title or Position	:	PHYSICIAN
Name	:	ALEXANDER LIPIN
Credential	:	M.D.
Telephone Number	:	781-268-2200

Provider Enumeration Date	:	11/09/2005
Last Update Date	:	08/22/2020

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