Provider Demographics
NPI:1538141825
Name:LUNDY, NANCY ANN (EDD)
Entity Type:Individual
Prefix:DR
First Name:NANCY
Middle Name:ANN
Last Name:LUNDY
Suffix:
Gender:F
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 POTTER ST
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:MA
Mailing Address - Zip Code:01742-3510
Mailing Address - Country:US
Mailing Address - Phone:978-369-8651
Mailing Address - Fax:617-726-2894
Practice Address - Street 1:40 POTTER ST
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:MA
Practice Address - Zip Code:01742-3510
Practice Address - Country:US
Practice Address - Phone:978-369-8651
Practice Address - Fax:617-726-2894
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2510103T00000X, 103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologist
Not Answered103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAW02680OtherBCBS MA
MA0523755Medicaid
MAW02680Medicare ID - Type Unspecified