Provider Demographics
NPI:1851378368
Name:NORTON, LISA E (MD)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:E
Last Name:NORTON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:850 HARRISON AVENUE
Mailing Address - Street 2:YACC-BNC7
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02118-4001
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:850 HARRISON AVENUE
Practice Address - Street 2:YACC, 3RD FLOOR
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02118-4001
Practice Address - Country:US
Practice Address - Phone:617-638-6100
Practice Address - Fax:617-638-6179
Is Sole Proprietor?:No
Enumeration Date:2005-12-27
Last Update Date:2013-10-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA76803207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110053006AMedicaid
MA110053006AMedicaid
MACX6649Medicare PIN
MAJ13921Medicare PIN