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NPI Code Detail

MEDICARE: NARAYANA R LEBAKA MD

MEDICARE: NARAYANA R LEBAKA 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
1207R00000XInternal Medicine PhysicianIN PROCESSINGGA
2208M00000XHospitalist Physician244413MA
3207R00000XInternal Medicine Physician244413MA

General Provider Information

NPI Number : 1538390752
Entity Type Code : Individual
Provider Name (Legal Business Name) : NARAYANA R LEBAKA MD
Provider Business Mailing Address
First Line : 280 CHESTNUT STREET
Second Line : 2ND FLOOR
City : SPRINGFIELD
State : MA
Zip : 01199
Country : US
Telephone Number : 413-794-5700
Fax Number :
Provider Business Practice Location Address
First Line : 85 SOUTH STREET
Second Line :
City : WARE
State : MA
Zip : 01082-1625
Country : US
Telephone Number : 413-967-2201
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/05/2009
Last Update Date : 03/15/2011

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