Provider Demographics
NPI:1447211503
Name:GREATER LOWELL FAMILY PRACTICE PC
Entity Type:Organization
Organization Name:GREATER LOWELL FAMILY PRACTICE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:NEWTON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:978-851-4141
Mailing Address - Street 1:600 CLARK RD
Mailing Address - Street 2:
Mailing Address - City:TEWKSBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01876-1699
Mailing Address - Country:US
Mailing Address - Phone:978-851-4141
Mailing Address - Fax:978-788-7911
Practice Address - Street 1:600 CLARK RD
Practice Address - Street 2:
Practice Address - City:TEWKSBURY
Practice Address - State:MA
Practice Address - Zip Code:01876-1699
Practice Address - Country:US
Practice Address - Phone:978-453-8446
Practice Address - Fax:978-453-0621
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-29
Last Update Date:2020-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA47300OtherCIGNA HEALTHCARE
MA9785329Medicaid
MACH0509OtherRAILROAD MEDICARE
MAM17209OtherBLUE CROSS BLUE SHIELD
MA0020561OtherNEIGHBORHOOD HEALTH
MA103269000OtherFEDERAL WORKERS COMP.
MD38888OtherFALLON COMMUNITY HEALTH
MA668793OtherTUFTS HEALTH PLAN
MA0101333OtherUNITED HEALTHCARE