Provider Demographics
NPI:1881688323
Name:LUNG SPECIALISTS OF MERRIMACK
Entity Type:Organization
Organization Name:LUNG SPECIALISTS OF MERRIMACK
Other - Org Name:LUNG SPECIALISTS OF THE MERRIMACK VALLEY, P.C.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:DENIS
Authorized Official - Middle Name:Y
Authorized Official - Last Name:LIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:978-934-9220
Mailing Address - Street 1:275 VARNUM AVE
Mailing Address - Street 2:SUITE 203
Mailing Address - City:LOWELL
Mailing Address - State:MA
Mailing Address - Zip Code:01854-2109
Mailing Address - Country:US
Mailing Address - Phone:978-934-9220
Mailing Address - Fax:978-453-7771
Practice Address - Street 1:275 VARNUM AVE
Practice Address - Street 2:SUITE 203
Practice Address - City:LOWELL
Practice Address - State:MA
Practice Address - Zip Code:01854-2109
Practice Address - Country:US
Practice Address - Phone:978-934-9220
Practice Address - Fax:978-453-7771
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-09
Last Update Date:2016-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care MedicineGroup - Multi-Specialty
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110068782AMedicaid
MAM21182Medicare PIN