MEDICARE: DR. ALYSSA ANN LEBEL 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	2084P2900X	Pain Medicine (Psychiatry & Neurology) Physician	54989	MA

General Provider Information

NPI Number	:	1235123381
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALYSSA ANN LEBEL MD

Provider Business Mailing Address
First Line	:	333 LONGWOOD AVE FL 5
Second Line	:
City	:	BOSTON
State	:	MA
Zip	:	02115-5711
Country	:	US
Telephone Number	:	617-355-7040
Fax Number	:

Provider Business Practice Location Address
First Line	:	333 LONGWOOD AVE FL 5
Second Line	:
City	:	BOSTON
State	:	MA
Zip	:	02115-5711
Country	:	US
Telephone Number	:	617-355-7040
Fax Number	:

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

Provider Enumeration Date	:	09/06/2005
Last Update Date	:	08/17/2007

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