Provider Demographics
NPI:1740261437
Name:PSYCHIATRIC ASSOCIATES OF LYNN
Entity type:Organization
Organization Name:PSYCHIATRIC ASSOCIATES OF LYNN
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:ALEXANDER
Authorized Official - Middle Name:
Authorized Official - Last Name:LIPIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:781-268-2200
Mailing Address - Street 1:350 REVERE BEACH BLVRD APT.# 9-10P
Mailing Address - Street 2:
Mailing Address - City:REVERE
Mailing Address - State:MA
Mailing Address - Zip Code:02151-4866
Mailing Address - Country:US
Mailing Address - Phone:781-286-5619
Mailing Address - Fax:
Practice Address - Street 1:350 REVERE BEACH BLVD
Practice Address - Street 2:
Practice Address - City:REVERE
Practice Address - State:MA
Practice Address - Zip Code:02151-4866
Practice Address - Country:US
Practice Address - Phone:781-286-5619
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA210779261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health