Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VG0400X | Gynecologist | 56101 | MA |
NPI | 1053311076 |
---|---|
Provider Name | Dr. Linda H Leavenworth |
First Address | Acton, MA 01720-3739 |
Second Address | Acton, MA 01720-3739 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/08/2005 |
Last Update Date | 15/08/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
056101 | TUFTS HEALTH PLAN (01) | MA |
13614 | HARVARD PILGRIM HEALTH (01) | MD |
2018428 | AETNA INSURANCE (01) | MA |
3023311 | (05) | MA |
82830 | FALLON INSURANCE (01) | MD |
A59142 | (02) | MA |
J06513 | BLUE CROSS & BLUE SHIELD (01) | MA |