Provider Demographics
NPI:1447202981
Name:LAHEY, ALLEN CHARLES (DO)
Entity Type:Individual
Prefix:DR
First Name:ALLEN
Middle Name:CHARLES
Last Name:LAHEY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 EDWARD ST
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:MA
Mailing Address - Zip Code:02021-2303
Mailing Address - Country:US
Mailing Address - Phone:781-828-3533
Mailing Address - Fax:781-828-2471
Practice Address - Street 1:42 TREMONT ST
Practice Address - Street 2:
Practice Address - City:DUXBURY
Practice Address - State:MA
Practice Address - Zip Code:02332-5300
Practice Address - Country:US
Practice Address - Phone:781-934-0709
Practice Address - Fax:781-934-2916
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-16
Last Update Date:2008-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA30392207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3002497Medicaid
0100664OtherUNITED HC
MAM14706OtherBLUE CROSS & BLUE SHIELD
MAJ03968OtherBLUE CROSS & BLUE SHIELD
MA0551409OtherUS HEALTH
7877OtherHARVARD PILGRIM HC
7877OtherHARVARD PILGRIM HC
MAJ03968Medicare ID - Type Unspecified