Healthcare Provider Details

I. General information

NPI: 1750495974
Provider Name (Legal Business Name): BEDFORD-LEXINGTON INTERNAL MEDICINE, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/17/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

450 BEDFORD ST
LEXINGTON MA
02420-1535
US

IV. Provider business mailing address

450 BEDFORD ST
LEXINGTON MA
02420-1535
US

V. Phone/Fax

Practice location:
  • Phone: 781-274-6274
  • Fax: 781-862-1472
Mailing address:
  • Phone: 781-274-6274
  • Fax: 781-862-1472

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. NORMAN S WEINBERG
Title or Position: PRESIDENT
Credential: M.D.
Phone: 781-274-6274