Provider Demographics
NPI:1619691045
Name:GIROUX, LINDSEY JAE
Entity Type:Individual
Prefix:
First Name:LINDSEY
Middle Name:JAE
Last Name:GIROUX
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 WINDEMERE RD
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01602-4152
Mailing Address - Country:US
Mailing Address - Phone:508-612-8729
Mailing Address - Fax:
Practice Address - Street 1:72 CUDWORTH RD
Practice Address - Street 2:
Practice Address - City:WEBSTER
Practice Address - State:MA
Practice Address - Zip Code:01570-3157
Practice Address - Country:US
Practice Address - Phone:508-461-0011
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-29
Last Update Date:2022-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN284148207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine