Provider Demographics
NPI:1700888419
Name:LENTINI, ELIZABETH BORNHOLDT (MD)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:BORNHOLDT
Last Name:LENTINI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:BORNHOLDT
Other - Last Name:PRITCHARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:ANDOVER PEDIATRICS NPI 1548393176
Mailing Address - Street 2:203 TURNPIKE ST, SUITE 200
Mailing Address - City:NORTH ANDOVER
Mailing Address - State:MA
Mailing Address - Zip Code:01845
Mailing Address - Country:US
Mailing Address - Phone:978-475-4522
Mailing Address - Fax:978-688-6047
Practice Address - Street 1:ANDOVER PEDIATRICS NPI 1548393176
Practice Address - Street 2:203 TURNPIKE ST, SUITE 200
Practice Address - City:NORTH ANDOVER
Practice Address - State:MA
Practice Address - Zip Code:01845
Practice Address - Country:US
Practice Address - Phone:978-475-4522
Practice Address - Fax:978-688-6047
Is Sole Proprietor?:No
Enumeration Date:2005-08-12
Last Update Date:2024-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA154816208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1211978Medicaid
G51673Medicare UPIN
J17855Medicare ID - Type Unspecified