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Individual

LILI A GOTTFRIED

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
77 MASS AVE, MEDICAL E23-395, CAMBRIDGE, MA 02139-4301
(617) 253-2916
Mailing address
PO BOX 425789, MEDICAL E23-395, CAMBRIDGE, MA 02142-0015
(617) 253-2916

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
39780
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
B11587
BLUE CROSS
MA
Enumeration date
02/21/2006
Last updated
07/08/2007
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