Jacob Ibrook Tower
Otolaryngologist (ENT Doctor) Otolaryngology/Facial Plastic Surgery
Lahey Clinic 41 Mall Road
Burlington
, Massachusetts 01805-0001
Jacob Ibrook Tower
Otolaryngologist (ENT Doctor) Otolaryngology/Facial Plastic Surgery
Lahey Clinic 41 Mall Road
Burlington
, Massachusetts 01805-0001
(781) 744-8085
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About
Features
Specialties
- Otolaryngologist (ENT Doctor)
- Otolaryngology/Facial Plastic Surgery
Languages spoken
- English
Location
First Address
- Jacob Ibrook Tower
- Lahey Provider Enrollment Department 41 Mall Road
- Burlington, MA
- Zip : 01805-0001
- Phone : (781) 744-8085
Second Address
- Jacob Ibrook Tower
- Lahey Clinic 41 Mall Road
- Burlington, MA
- Zip : 01805-0001
- Phone : (781) 744-8085
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207Y00000X | Otolaryngologist (ENT Doctor) | 288000 | MA |
| N | 207YX0905X | Otolaryngology/Facial Plastic Surgery | 303409 | NY |
National Provider Identifier
| NPI | 1437538881 |
|---|---|
| Provider Name | Jacob Ibrook Tower |
| First Address | Burlington, MA 01805-0001 |
| Second Address | Burlington, MA 01805-0001 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 19/05/2015 |
| Last Update Date | 24/09/2021 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.