1497773584 NPI number — DR. BARRY LESTER LEVIN M.D.

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1497773584 NPI number — DR. BARRY LESTER LEVIN M.D.

Employer Identification Number (EIN):

Provider Organization Name:

Provider Last Name:

LEVIN

Provider First Name:

BARRY

Provider Middle Name:

LESTER

Provider Name Prefix Text:

DR.

Provider Name Suffix Text:

Provider Credential Text:

M.D.

Provider Gender Code:

M

Provider Other Organization Name:

Provider Other Organization Name Type Code:

Provider Other Last Name:

Provider Other First Name:

Provider Other Middle Name:

Provider Other Name Prefix Text:

Provider Other Name Suffix Text:

Provider Other Credential Text:

Provider Other Last Name Type Code:

NPI Number:

1497773584

Entity Type Code:

Individual

Replacement NPI:

Last Update Date:

08/27/2012

NPI Deactivation Reason Code:

NPI Deactivation Date:

NPI Reactivation Date:

Provider First Line Business Mailing Address:

PO BOX 845039

Provider Second Line Business Mailing Address:

Provider Business Mailing Address City Name:

BOSTON

Provider Business Mailing Address State Name:

MA

Provider Business Mailing Address Postal Code:

02284-5039

Provider Business Mailing Address Country Code:

US

Provider Business Mailing Address Telephone Number:

Provider Business Mailing Address Fax Number:

Provider First Line Business Practice Location Address:

SUITE 760

Provider Second Line Business Practice Location Address:

131 ORNAC

Provider Business Practice Location Address City Name:

CONCORD

Provider Business Practice Location Address State Name:

MA

Provider Business Practice Location Address Postal Code:

01743-4181

Provider Business Practice Location Address Country Code:

US

Provider Business Practice Location Address Telephone Number:

978-341-0060

Provider Business Practice Location Address Fax Number:

978-341-0063

Provider Enumeration Date:

07/17/2006

Authorized Official Last Name:

Authorized Official First Name:

Authorized Official Middle Name:

Authorized Official Title or Position:

Authorized Official Telephone Number:

• Taxonomy code: 2084N0400X , with the licence number:  52012 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

• Identifier: J29249 . This is a "MEDEX" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
• Identifier: 6146511 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
• Identifier: 712959 . This is a "TUFTS HEALTH PLAN" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
• Identifier: 96741 . This is a "FALLON COMMUNITY HEALTHCA" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
• Identifier: 11029 . This is a "HARVARD PILGRIM HEALTHCAR" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
• Identifier: 1117362 . This is a "AETNA" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
• Identifier: 130024913 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
• Identifier: 6146511 . This is a "E D S" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
• Identifier: 2121133 . This is a "CIGNA HEALTHCARE" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
• Identifier: 11029 . This is a "HARVARD FIRST SENIORITY" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
• Identifier: 712959 . This is a "TUFTS MEDICARE PREFERRED" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
• Identifier: J29249 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".