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General NPI Number Information
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NPI Number | 1164577995
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Entity Type | Organization
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Legal Business Name | BARRY L LEVIN MD
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Dates
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Enumeration Date | 01/24/2007
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Last Update Date | 06/19/2008
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Provider Practice Location Address
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Address Line | 131 ORNAC SUITE 760
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City | CONCORD
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State | MA
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Zip | 01742-4181
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Country | US
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Telephone | 978-341-0060
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Fax | 978-341-0063
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Provider Business Mailing Address
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Address Line | PO BOX 845039
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City | BOSTON
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State | MA
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Zip | 02284-5039
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Country | US
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Telephone | 978-341-0060
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Fax | 978-341-0063
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Authorized Official
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Title or Position | OWNER OF PRACTICE
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Name | DR. BARRY LESTER LEVIN
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Credential | MD
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Telephone | 978-341-0060
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 52012
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License Number State | MA
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