Basic Information
| Provider Information | |||||||||
| NPI: | 1518050384 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | TRODDEN | ||||||||
| FirstName: | LYNN | ||||||||
| MiddleName: | S. | ||||||||
| NamePrefix: | MS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | P.T. | ||||||||
| OtherOrganizationName: | |||||||||
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| OtherLastName: | |||||||||
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| OtherCredential: | |||||||||
| OtherLastNameType: | |||||||||
| Mailing Information | |||||||||
| Address1: | 1 ARROW DR | ||||||||
| Address2: | SUITE 2 | ||||||||
| City: | WOBURN | ||||||||
| State: | MA | ||||||||
| PostalCode: | 018012039 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7819352655 | ||||||||
| FaxNumber: | 7819359097 | ||||||||
| Practice Location | |||||||||
| Address1: | 1 ARROW DR | ||||||||
| Address2: | SUITE 2 | ||||||||
| City: | WOBURN | ||||||||
| State: | MA | ||||||||
| PostalCode: | 018012039 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7819352655 | ||||||||
| FaxNumber: | 7819359097 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/02/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| AuthorizedOfficialTelephone: | |||||||||
| IsSoleProprietor: | Y | ||||||||
| IsOrganizationSubpart: | |||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 174400000X | 13340 | MA | Y | Other Service Providers | Specialist |
No ID Information.