Individual
DR. MARTHA KOUTSOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
LAHEY CLINIC, 41 MALL ROAD, BURLINGTON, MA 01805-0001
(781) 744-8869
(781) 744-5235
Mailing address
LAHEY CLINIC, 41 MALL ROAD, BURLINGTON, MA 01805-0001
(781) 744-8869
(781) 744-5235
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
72757
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110034795A
—
MA
05
—
2020947
—
MA
Enumeration date
07/25/2006
Last updated
09/30/2011
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