Basic Information
Provider Information
NPI: 1801168042
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HOWLETT
FirstName: MICHELLE
MiddleName: E.
NamePrefix:  
NameSuffix:  
Credential: PA
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: CASSIM
OtherFirstName: MICHELLE
OtherMiddleName: E.
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential: PA
OtherLastNameType: 1
Mailing Information
Address1: LAHEY CLINIC
Address2: 41 MALL ROAD
City: BURLINGTON
State: MA
PostalCode: 018050001
CountryCode: US
TelephoneNumber: 7817448243
FaxNumber: 7817442945
Practice Location
Address1: LAHEY CLINIC
Address2: 41 MALL ROAD
City: BURLINGTON
State: MA
PostalCode: 018050001
CountryCode: US
TelephoneNumber: 7817448243
FaxNumber: 7817442945
Other Information
ProviderEnumerationDate: 02/03/2012
LastUpdateDate: 11/01/2012
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363A00000X4350MAY Physician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant 

No ID Information.


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