MEDICARE: DR. LESLYE ROBIN HEILIG MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	073130	MA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	26955	OTHER	MVP
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	817410	OTHER	UNITED HEALTH
4	P625198	OTHER	OXFORD
5	000000020948	OTHER	BMC HEALTHNET
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	10275301	OTHER	CIGNA
8	MA0479	OTHER	HEALTHNET OF THE NE, INC.
9	073130	OTHER	CTCARE
10	10029273	OTHER	CDPHP
11	28100	OTHER	CHILDRENS MEDICAL
12	12991	OTHER	HEALTH NEW ENGLAND
13	073130	OTHER	TUFTS HEALTH PLAN
14	A64448	OTHER	HARVARD PILGRIM HEALTH
15	J10138	OTHER	BCBS OF MA

General Provider Information

NPI Number	:	1235122417
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LESLYE ROBIN HEILIG MD

Provider Business Mailing Address
First Line	:	100 MAPLE AVE STE 1
Second Line	:
City	:	GREAT BARRINGTON
State	:	MA
Zip	:	01230-1965
Country	:	US
Telephone Number	:	413-528-4047
Fax Number	:	413-528-3407

Provider Business Practice Location Address
First Line	:	100 MAPLE AVE STE 1
Second Line	:
City	:	GREAT BARRINGTON
State	:	MA
Zip	:	01230-1965
Country	:	US
Telephone Number	:	413-528-4047
Fax Number	:	413-528-3407

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/24/2005
Last Update Date	:	08/27/2007

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