Basic Information
Provider Information
NPI: 1063056992
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: FOSHER
FirstName: LYNDSEY
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 83 MAIN ST APT 2B
Address2:  
City: EXETER
State: NH
PostalCode: 038332466
CountryCode: US
TelephoneNumber: 6034185380
FaxNumber:  
Practice Location
Address1: 132 ROBBS HILL RD
Address2:  
City: LUNENBURG
State: MA
PostalCode: 014622167
CountryCode: US
TelephoneNumber: 7742701766
FaxNumber: 5088610206
Other Information
ProviderEnumerationDate: 11/04/2019
LastUpdateDate: 11/04/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
106S00000X  Y    

No ID Information.


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