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General NPI Number Information
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NPI Number | 1588926927
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Entity Type | Individual
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Provider Name | MOLLY S. LEDERMAN MD
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Gender | Female
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Dates
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Enumeration Date | 06/12/2012
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Last Update Date | 03/30/2021
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Provider Practice Location Address
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Address Line | 57 BEDFORD ST
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City | LEXINGTON
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State | MA
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Zip | 02420-4500
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Country | US
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Telephone | 781-862-4110
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Fax |
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Provider Business Mailing Address
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Address Line | 248 TREMONT ST
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City | NEWTON
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State | MA
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Zip | 02458-2114
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Country | US
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Telephone | 617-877-1215
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 262574
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License Number State | MA
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