Provider Demographics
NPI:1457773541
Name:LIANNE INC
Entity Type:Organization
Organization Name:LIANNE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MOHAMMAD
Authorized Official - Middle Name:
Authorized Official - Last Name:ALHABBAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:508-414-0200
Mailing Address - Street 1:21 COLONIAL DR
Mailing Address - Street 2:
Mailing Address - City:SHREWSBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01545-1522
Mailing Address - Country:US
Mailing Address - Phone:508-755-1222
Mailing Address - Fax:855-999-9140
Practice Address - Street 1:200 LINCOLN ST
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01605-2528
Practice Address - Country:US
Practice Address - Phone:508-755-1222
Practice Address - Fax:855-999-9140
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LIANNE INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-01-09
Last Update Date:2015-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA229350207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty