Individual
DR. LYDIA C SIEGEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD, MPH
Contact information
Practice address
301 SOUTH HUNTINGTON AVENUE, JAMAICA PLAIN, MA 02130
(857) 307-3300
(857) 307-3305
Mailing address
111 CYPRESS STREET, BOSTON, MA 02445
(857) 307-3300
(857) 307-3305
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
226444
MA
207R00000X
Internal Medicine Physician
Primary
226444
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2119064
—
MA
Enumeration date
12/21/2005
Last updated
07/12/2012
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