Provider Demographics
NPI:1811419823
Name:LINCOLN MEDICAL PRACTICE
Entity Type:Organization
Organization Name:LINCOLN MEDICAL PRACTICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMILA
Authorized Official - Middle Name:
Authorized Official - Last Name:HASSAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-344-9899
Mailing Address - Street 1:124 CANAL ST STE C
Mailing Address - Street 2:
Mailing Address - City:LEWISTON
Mailing Address - State:ME
Mailing Address - Zip Code:04240-7711
Mailing Address - Country:US
Mailing Address - Phone:207-344-9899
Mailing Address - Fax:877-712-8183
Practice Address - Street 1:124 CANAL ST STE C
Practice Address - Street 2:
Practice Address - City:LEWISTON
Practice Address - State:ME
Practice Address - Zip Code:04240-7711
Practice Address - Country:US
Practice Address - Phone:207-344-9899
Practice Address - Fax:877-712-8183
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-11
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care