Basic Information
Provider Information
NPI: 1508963208
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: LAMB
FirstName: CARLA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: LAHEY CLINIC
Address2: 41 MALL ROAD
City: BURLINGTON
State: MA
PostalCode: 018050001
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 41 MALL RD
Address2:  
City: BURLINGTON
State: MA
PostalCode: 018050001
CountryCode: US
TelephoneNumber: 7817448000
FaxNumber: 7817448988
Other Information
ProviderEnumerationDate: 09/17/2006
LastUpdateDate: 11/16/2010
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RP1001X215259MAY Allopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
207RC0200X215259MAN Allopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
207R00000X215259MAN Allopathic & Osteopathic PhysiciansInternal Medicine 

ID Information
IDTypeStateIssuerDescription
110006294A05MA MEDICAID
017699105MA MEDICAID


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