Provider Demographics
NPI:1053488692
Name:NARUSEVICIUS, LILY S (MD)
Entity Type:Individual
Prefix:
First Name:LILY
Middle Name:S
Last Name:NARUSEVICIUS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:30 NEW CROSSING RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:READING
Mailing Address - State:MA
Mailing Address - Zip Code:01867-3270
Mailing Address - Country:US
Mailing Address - Phone:781-213-5170
Mailing Address - Fax:781-213-5175
Practice Address - Street 1:30 NEW CROSSING RD
Practice Address - Street 2:SUITE 200
Practice Address - City:READING
Practice Address - State:MA
Practice Address - Zip Code:01867-3270
Practice Address - Country:US
Practice Address - Phone:781-213-5170
Practice Address - Fax:781-213-5175
Is Sole Proprietor?:No
Enumeration Date:2006-11-29
Last Update Date:2012-05-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA234390207R00000X
GA037308207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00568378BMedicaid
GA00568378BMedicaid
GA11BDVJ2Medicare PIN