Provider Demographics
NPI:1003961988
Name:RICH, LILLIAN (MD)
Entity Type:Individual
Prefix:
First Name:LILLIAN
Middle Name:
Last Name:RICH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:60 HOSPITAL RD
Mailing Address - Street 2:WACHUSETT EMERGENCY PHYSICIANS
Mailing Address - City:LEOMINSTER
Mailing Address - State:MA
Mailing Address - Zip Code:01453-2205
Mailing Address - Country:US
Mailing Address - Phone:978-466-2994
Mailing Address - Fax:978-466-2993
Practice Address - Street 1:60 HOSPITAL RD
Practice Address - Street 2:WACHUSETT EMERGENCY PHYSICIANS
Practice Address - City:LEOMINSTER
Practice Address - State:MA
Practice Address - Zip Code:01453-2205
Practice Address - Country:US
Practice Address - Phone:978-466-2994
Practice Address - Fax:978-466-2993
Is Sole Proprietor?:No
Enumeration Date:2007-01-24
Last Update Date:2008-09-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA235627207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA000608701OtherMEDICARE
MA2154072Medicaid
MAJ43270OtherBLUE CROSS/BLUE SHIELD