Provider Demographics
NPI:1891118873
Name:PERSONALIZED MEDICAL CARE LLC
Entity Type:Organization
Organization Name:PERSONALIZED MEDICAL CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LAWRENCE
Authorized Official - Middle Name:
Authorized Official - Last Name:STARR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:617-529-8041
Mailing Address - Street 1:200 BOYLSTON ST
Mailing Address - Street 2:SUITE 311
Mailing Address - City:CHESTNUT HILL
Mailing Address - State:MA
Mailing Address - Zip Code:02467-2012
Mailing Address - Country:US
Mailing Address - Phone:617-529-8041
Mailing Address - Fax:
Practice Address - Street 1:200 BOYLSTON ST
Practice Address - Street 2:SUITE 311
Practice Address - City:CHESTNUT HILL
Practice Address - State:MA
Practice Address - Zip Code:02467-2012
Practice Address - Country:US
Practice Address - Phone:617-529-8041
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-28
Last Update Date:2014-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA48001207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty