Healthcare Provider Details

I. General information

NPI: 1003832635
Provider Name (Legal Business Name): LESLIE A DUBINSKY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/15/2006
Last Update Date: 02/11/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40 WRIGHT ST
PALMER MA
01069
US

IV. Provider business mailing address

40 WRIGHT ST
PALMER MA
01069
US

V. Phone/Fax

Practice location:
  • Phone: 413-284-5276
  • Fax: 413-284-5117
Mailing address:
  • Phone: 413-283-7651
  • Fax: 413-284-5117

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number212524
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: