Provider Demographics
NPI:1477522852
Name:LAWRENCE NEWMAN MD & PENELOPE HALL MD
Entity Type:Organization
Organization Name:LAWRENCE NEWMAN MD & PENELOPE HALL MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LAWRENCE
Authorized Official - Middle Name:
Authorized Official - Last Name:NEWMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:978-663-3410
Mailing Address - Street 1:PO BOX 1807
Mailing Address - Street 2:
Mailing Address - City:MERRIMACK
Mailing Address - State:NH
Mailing Address - Zip Code:03054-1807
Mailing Address - Country:US
Mailing Address - Phone:603-673-9411
Mailing Address - Fax:603-673-9899
Practice Address - Street 1:572 BOSTON RD
Practice Address - Street 2:
Practice Address - City:BILLERICA
Practice Address - State:MA
Practice Address - Zip Code:01821-3776
Practice Address - Country:US
Practice Address - Phone:978-663-3410
Practice Address - Fax:603-670-8110
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA9777075Medicaid
MA455592OtherAETNA
MAM16118OtherBLUE CROSS BLUE SHIELD
MA21556OtherFALLON COMMUNITY HEALTH
MA605020OtherTUFTS HEALTH PLAN
MA605020OtherTUFTS HEALTH PLAN
CN5048Medicare ID - Type UnspecifiedRAILROAD MEDICARE