Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 71822 | MA |
Y | 2080P0205X | Pediatric Endocrinologist | 71822 | MA |
NPI | 1164412896 |
---|---|
Provider Name | Dr. Lynne L Levitsky |
First Address | Charlestown, MA 02129-9142 |
Second Address | Boston, MA 02114-2621 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/10/2005 |
Last Update Date | 23/07/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
071822 | TUFTS HEALTH PLAN (01) | MA |
3057640 | (05) | MA |
C39169 | (02) | |
J09202 | BCBS MA (01) | MA |