Individual
LILIANE K YACOUB
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
70 EAST ST, ATTN PATHOLOGY DEPT, METHUEN, MA 01844-4597
(978) 687-0156
(978) 691-5709
Mailing address
460 TOTTEN POND RD, C/O MZI, WALTHAM, MA 02451-1991
(781) 890-9933
(781) 890-9930
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
81649
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3159621
—
MA
01
—
34738
HPHC
MA
01
—
767113
TUFTS
MA
01
—
J17222
BCBS
MA
Enumeration date
10/18/2005
Last updated
02/25/2010
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