Individual
DR. LYNN BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
15 PARKMAN ST, WAC 1, BOSTON, MA 02114-3117
(617) 726-2707
Mailing address
PO BOX 9142, MASS GENERAL PHYSICIAN ORGANIZATION, CHARLESTOWN, MA 02129-9142
(617) 726-2707
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
78415
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3118720
—
MA
01
—
733366
TUFTS HEALTH PLAN
MA
01
—
J14379
BCBS MA
MA
Enumeration date
10/28/2005
Last updated
07/19/2012
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