Provider Demographics
NPI:1275291494
Name:OPHEL, LINDSAY KATHERINE (PA-C)
Entity Type:Individual
Prefix:
First Name:LINDSAY
Middle Name:KATHERINE
Last Name:OPHEL
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 BELLVISTA RD APT 2
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02135-7612
Mailing Address - Country:US
Mailing Address - Phone:973-738-3619
Mailing Address - Fax:
Practice Address - Street 1:260 TREMONT ST FL 456
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02116-5603
Practice Address - Country:US
Practice Address - Phone:973-738-3619
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-05
Last Update Date:2021-12-05
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant