Provider Demographics
NPI:1619429198
Name:MCNAB, LESTER
Entity Type:Individual
Prefix:
First Name:LESTER
Middle Name:
Last Name:MCNAB
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:99 DRACUT ST
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:MA
Mailing Address - Zip Code:01843-2533
Mailing Address - Country:US
Mailing Address - Phone:617-272-0126
Mailing Address - Fax:
Practice Address - Street 1:99 DRACUT ST
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:MA
Practice Address - Zip Code:01843-2533
Practice Address - Country:US
Practice Address - Phone:617-272-0126
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-31
Last Update Date:2016-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health