NORTHEAST PHYSICIAN PRACTICE NPI 1750319547

NPI Information

  • NPI: 1750319547
  • Provider Name: NORTHEAST PHYSICIAN PRACTICE
  • Classification: Clinic/Center - 261QP2300X
  • Specialization: Primary Care
  • Entity Type: Organization
  • Doing Business As: LYNNFIELD PRIMARY
  • Address: 628 SALEM ST
    LYNNFIELD, MA
    ZIP 01940
  • Phone: (781) 598-4424

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NPI Details

NORTHEAST PHYSICIAN PRACTICE is a primary care clinic center in Lynnfield, MA. NORTHEAST PHYSICIAN PRACTICE NPI is 1750319547. The provider is registered as an organization entity type.
The provider Is Doing Business As Lynnfield Primary.

The provider's business location address is:

628 SALEM ST
LYNNFIELD, MA
ZIP 01940-340
Phone: (781) 598-4424
Fax: (781) 598-0630

The provider's authorized official is Kim Rouillard .
The authorized official title is Credentialing Manager and has the following contact phone number (978) 236-1713.

The enumeration date for this NPI number is 6/29/2006 and was last updated on 10/25/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QP2300XClinic/CenterPrimary CareYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1M21089MEDICARE ID-TYPE UNSPECIFIEDMASSACHUSETTS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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