Basic Information
Provider Information
NPI: 1144269143
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: AHN
FirstName: LYNNE
MiddleName: B
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 475 FRANKLIN ST
Address2: STE 110
City: FRAMINGHAM
State: MA
PostalCode: 017026265
CountryCode: US
TelephoneNumber: 5088940400
FaxNumber: 5088940617
Practice Location
Address1: 475 FRANKLIN ST STE 110
Address2:  
City: FRAMINGHAM
State: MA
PostalCode: 017026265
CountryCode: US
TelephoneNumber: 5086209200
FaxNumber: 5086206483
Other Information
ProviderEnumerationDate: 06/05/2006
LastUpdateDate: 01/03/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RG0100X212256MAY Allopathic & Osteopathic PhysiciansInternal MedicineGastroenterology

No ID Information.


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