Provider Demographics
NPI:1154329134
Name:LAMONT, JEFFREY S (MD)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:S
Last Name:LAMONT
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:340 MAIN ST
Mailing Address - Street 2:STE. 670
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01608-1604
Mailing Address - Country:US
Mailing Address - Phone:508-754-3566
Mailing Address - Fax:508-438-6364
Practice Address - Street 1:2000 WASHINGTON ST
Practice Address - Street 2:STE 443
Practice Address - City:NEWTON
Practice Address - State:MA
Practice Address - Zip Code:02462-1650
Practice Address - Country:US
Practice Address - Phone:617-527-1716
Practice Address - Fax:617-965-9446
Is Sole Proprietor?:No
Enumeration Date:2005-07-13
Last Update Date:2011-10-05
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Provider Licenses
StateLicense IDTaxonomies
MA73841208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3082911Medicaid
MAJ10985Medicare PIN
MA3082911Medicaid