Provider Demographics
NPI:1134196710
Name:LANNON, CATHERINE (MD)
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:
Last Name:LANNON
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:960 MASSACHUSETTS AVE
Mailing Address - Street 2:FL 2
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02118-2690
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:736 CAMBRIDGE ST
Practice Address - Street 2:
Practice Address - City:BRIGHTON
Practice Address - State:MA
Practice Address - Zip Code:02135-2907
Practice Address - Country:US
Practice Address - Phone:617-789-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-02
Last Update Date:2025-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA205598207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA20-1540574OtherGREAT-WEST
MAAA21778OtherHARVARD PILGRIM
MA20-1540574OtherPRIVATE HEALTHCARE SYSTEM
MA000000028846OtherBMC
MA20-1540574OtherUNICARE/GIC
MA20-1540574OtherCONSOLIDATED
MA35044OtherHEALTH NEW ENGLAND
MA20-1540574OtherPLAN VISTA
MA205598OtherCONNECTICARE
MA20-1540574OtherNORTH AMERICAN PREFERRED
MA20-1540574OtherNORTHEAST HEALTHCARE ALLI
MA20-1540574OtherNORTHEAST HEALTH DIRECT
MA2831457OtherCIGNA
MA32021520Medicaid
MA20-1540574OtherNORTHEAST HEALTH DIRECT
MA2831457OtherCIGNA