Provider Demographics
NPI:1003832635
Name:DUBINSKY, LESLIE A
Entity Type:Individual
Prefix:
First Name:LESLIE
Middle Name:A
Last Name:DUBINSKY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 WRIGHT ST
Mailing Address - Street 2:
Mailing Address - City:PALMER
Mailing Address - State:MA
Mailing Address - Zip Code:01069
Mailing Address - Country:US
Mailing Address - Phone:413-283-7651
Mailing Address - Fax:413-284-5117
Practice Address - Street 1:40 WRIGHT ST
Practice Address - Street 2:
Practice Address - City:PALMER
Practice Address - State:MA
Practice Address - Zip Code:01069
Practice Address - Country:US
Practice Address - Phone:413-284-5276
Practice Address - Fax:413-284-5117
Is Sole Proprietor?:No
Enumeration Date:2006-07-15
Last Update Date:2010-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA212524207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00096537OtherRR MEDICARE
976852OtherNETWORK HEALTH
212524OtherCONNECTICARE
2128263001OtherCIGNA
J24768OtherBLUE CROSS BLUE SHIELD
3547845OtherHEALTHSOURCE CMHC
MA0173908Medicaid
212524OtherTUFTS COMMUNITY HEALTH PL
212524OtherTUFTS COMMUNITY HEALTH PL
P00096537OtherRR MEDICARE