Basic Information
Provider Information
NPI: 1225253172
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: PARAB
FirstName: ANIKA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 41 MALL RD.
Address2: LAHEY CLINIC, INC.
City: BURLINGTON
State: MA
PostalCode: 018050001
CountryCode: US
TelephoneNumber: 7817448771
FaxNumber: 7817442905
Practice Location
Address1: 41 MALL RD.
Address2: LAHEY CLINIC
City: BURLINGTON
State: MA
PostalCode: 018050001
CountryCode: US
TelephoneNumber: 7817448100
FaxNumber: 7817445659
Other Information
ProviderEnumerationDate: 04/16/2007
LastUpdateDate: 03/02/2011
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207P00000XLP00526RIN Allopathic & Osteopathic PhysiciansEmergency Medicine 
207P00000X235439MAY Allopathic & Osteopathic PhysiciansEmergency Medicine 

ID Information
IDTypeStateIssuerDescription
215792605MA MEDICAID


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