Provider Demographics
NPI: | 1467532390 |
---|---|
Name: | LAMBERT, LAURA A (MD) |
Entity Type: | Individual |
Prefix: | |
First Name: | LAURA |
Middle Name: | A |
Last Name: | LAMBERT |
Suffix: | |
Gender: | F |
Credentials: | MD |
Other - Prefix: | |
Other - First Name: | |
Other - Middle Name: | |
Other - Last Name: | |
Other - Suffix: | |
Other - Last Name Type: | |
Other - Credentials: | |
Mailing Address - Street 1: | PO BOX 415348 |
Mailing Address - Street 2: | |
Mailing Address - City: | BOSTON |
Mailing Address - State: | MA |
Mailing Address - Zip Code: | 02241-5348 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 800-225-8885 |
Mailing Address - Fax: | 508-334-1977 |
Practice Address - Street 1: | 119 BELMONT ST |
Practice Address - Street 2: | DEPARTMENT OF SURGERY/SURGICAL ONCOLOGY |
Practice Address - City: | WORCESTER |
Practice Address - State: | MA |
Practice Address - Zip Code: | 01605-2903 |
Practice Address - Country: | US |
Practice Address - Phone: | 508-334-5220 |
Practice Address - Fax: | 508-334-5089 |
Is Sole Proprietor?: | No |
Enumeration Date: | 2006-10-16 |
Last Update Date: | 2021-11-17 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
MA | 238456 | 2086X0206X |
UT | 10497204-1205 | 208600000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 208600000X | Allopathic & Osteopathic Physicians | Surgery | |
No | 2086X0206X | Allopathic & Osteopathic Physicians | Surgery | Surgical Oncology |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
MA | 110081524A | Medicaid | |
MA | 000909101 | Medicare PIN | |
H99706 | Medicare UPIN |