Individual
DR. LAWRENCE EDWARD LIFSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
22 ELLIS RD, WEST NEWTON, MA 02465
(617) 964-8809
(617) 244-7852
Mailing address
22 ELLIS RD, WEST NEWTON, MA 02465
(617) 964-8809
(617) 244-7852
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
30111
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
B33358
BLUE CROSS BLUE SHIELD
MA
Enumeration date
02/02/2007
Last updated
07/08/2007
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