Provider Demographics
NPI:1558720532
Name:PAUL D. LAFONTAINE, M.D., P.C.
Entity Type:Organization
Organization Name:PAUL D. LAFONTAINE, M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLERK
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:D
Authorized Official - Last Name:LAFONTAINE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:617-547-4400
Mailing Address - Street 1:300 MOUNT AUBURN ST STE 519
Mailing Address - Street 2:SUITE 519
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02138-5665
Mailing Address - Country:US
Mailing Address - Phone:617-547-4400
Mailing Address - Fax:617-576-1076
Practice Address - Street 1:747 MAIN ST
Practice Address - Street 2:SUITE 214
Practice Address - City:CONCORD
Practice Address - State:MA
Practice Address - Zip Code:01742-3302
Practice Address - Country:US
Practice Address - Phone:978-369-1527
Practice Address - Fax:978-369-8745
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CAMBRIDGE UROLOGICAL ASSOCIATES, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-02-18
Last Update Date:2016-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty