Provider Demographics
NPI:1053693549
Name:ACKROYD, CHRISTINE (NP)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:
Last Name:ACKROYD
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:CHRISTINE
Other - Middle Name:
Other - Last Name:GEIER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:LAHEY CLINIC
Mailing Address - Street 2:41 MALL RD.
Mailing Address - City:BURLINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:01805-0001
Mailing Address - Country:US
Mailing Address - Phone:781-744-8460
Mailing Address - Fax:781-744-5261
Practice Address - Street 1:LAHEY CLINIC
Practice Address - Street 2:41 MALL RD.
Practice Address - City:BURLINGTON
Practice Address - State:MA
Practice Address - Zip Code:01805-0001
Practice Address - Country:US
Practice Address - Phone:781-744-8000
Practice Address - Fax:781-744-5261
Is Sole Proprietor?:No
Enumeration Date:2011-09-12
Last Update Date:2019-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN265156363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110090336AMedicaid
MA002436601Medicare PIN
MA002436602Medicare PIN