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NPI Code Detail

MEDICARE: LYNNE C GRAHAM O'BRIEN AUD, CCC-A

MEDICARE: LYNNE C GRAHAM O'BRIEN AUD, CCC-A
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
1231H00000XAudiologist574MA

General Provider Information

NPI Number : 1962477653
Entity Type Code : Individual
Provider Name (Legal Business Name) : LYNNE C GRAHAM O'BRIEN AUD, CCC-A
Provider Business Mailing Address
First Line : 9 DARLING ST
Second Line :
City : MARBLEHEAD
State : MA
Zip : 01945-3534
Country : US
Telephone Number : 617-306-3676
Fax Number :
Provider Business Practice Location Address
First Line : 40 ARMINGTON ST
Second Line :
City : ALLSTON
State : MA
Zip : 02134-2406
Country : US
Telephone Number : 617-635-8544
Fax Number : 617-635-6697
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/17/2006
Last Update Date : 04/27/2013

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