Provider Demographics
NPI:1700149598
Name:LENDER SEACOAST PC
Entity type:Organization
Organization Name:LENDER SEACOAST PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DR. LENDER/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JULIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:LENDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-264-9200
Mailing Address - Street 1:27 COMMERCIAL ST
Mailing Address - Street 2:
Mailing Address - City:GLOUCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01930-5033
Mailing Address - Country:US
Mailing Address - Phone:978-515-7804
Mailing Address - Fax:978-879-4813
Practice Address - Street 1:27 COMMERCIAL ST
Practice Address - Street 2:
Practice Address - City:GLOUCESTER
Practice Address - State:MA
Practice Address - Zip Code:01930-5033
Practice Address - Country:US
Practice Address - Phone:978-515-7804
Practice Address - Fax:978-879-4813
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-18
Last Update Date:2012-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN18692261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental