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NPI Code Detail

MEDICARE: MELVYN L LURIE M.D.

MEDICARE: MELVYN L LURIE M.D.
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
12084P0800XPsychiatry Physician33102MA

General Provider Information

NPI Number : 1932265865
Entity Type Code : Individual
Provider Name (Legal Business Name) : MELVYN L LURIE M.D.
Provider Business Mailing Address
First Line : 170 MORTON ST.
Second Line : MMBMHU--10 NORTH
City : BOSTON
State : MA
Zip : 02130
Country : US
Telephone Number : 617-510-8474
Fax Number :
Provider Business Practice Location Address
First Line : 170 MORTON ST
Second Line : MMBMHU--10 NORTH
City : BOSTON
State : MA
Zip : 02130-3735
Country : US
Telephone Number : 617-510-8474
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/28/2006
Last Update Date : 09/09/2009

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Directions to “ MELVYN L LURIE M.D.” Practice Location

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