Provider Demographics
NPI:1407393945
Name:LEXINGTON PSYCHIATRY LLC
Entity Type:Organization
Organization Name:LEXINGTON PSYCHIATRY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, MD
Authorized Official - Prefix:
Authorized Official - First Name:TILOTTOMA
Authorized Official - Middle Name:
Authorized Official - Last Name:MUKHERJEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-561-1600
Mailing Address - Street 1:1666 MASS AVE
Mailing Address - Street 2:FLOOR 2 SUITE 3
Mailing Address - City:LEXINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02420-5317
Mailing Address - Country:US
Mailing Address - Phone:781-561-1600
Mailing Address - Fax:781-538-4334
Practice Address - Street 1:1666 MASS AVE
Practice Address - Street 2:FLOOR 2 SUITE 3
Practice Address - City:LEXINGTON
Practice Address - State:MA
Practice Address - Zip Code:02420-5317
Practice Address - Country:US
Practice Address - Phone:781-561-1600
Practice Address - Fax:781-538-4334
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-23
Last Update Date:2017-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty