Provider Demographics
NPI:1679510317
Name:LUND, SALLYANNE (MD)
Entity Type:Individual
Prefix:
First Name:SALLYANNE
Middle Name:
Last Name:LUND
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37 MISS FRY DR
Mailing Address - Street 2:
Mailing Address - City:EAST GREENWICH
Mailing Address - State:RI
Mailing Address - Zip Code:02818-1244
Mailing Address - Country:US
Mailing Address - Phone:401-300-1808
Mailing Address - Fax:
Practice Address - Street 1:6 BUTTERFIELD RD
Practice Address - Street 2:URI HEALTH SERVICES
Practice Address - City:KINGSTON
Practice Address - State:RI
Practice Address - Zip Code:02881-1116
Practice Address - Country:US
Practice Address - Phone:401-300-1808
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1569282084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry