Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0106X | Orthopaedic Hand Surgeon | 45233 | MA |
NPI | 1043315567 |
---|---|
Provider Name | Bruce M. Leslie |
First Address | Newton, MA 02462-1650 |
Second Address | Newton, MA 02462-1650 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/09/2006 |
Last Update Date | 24/04/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
045233 | TUFTS (01) | MA |
17742 | HARVARD PILGRIM (01) | MA |
A36171 | (02) | MA |
B20204501 | CIGNA (01) | MA |
B39185 | BLUE CROSS BLUE SHIELD (01) | MA |