Provider Demographics
NPI:1003883513
Name:LENTZ, CONSTANCE B (MD)
Entity Type:Individual
Prefix:
First Name:CONSTANCE
Middle Name:B
Last Name:LENTZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 INFIRMARY WAY
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:MA
Mailing Address - Zip Code:01003-9288
Mailing Address - Country:US
Mailing Address - Phone:413-577-5000
Mailing Address - Fax:413-577-5440
Practice Address - Street 1:150 INFIRMARY WAY
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:MA
Practice Address - Zip Code:01003-9288
Practice Address - Country:US
Practice Address - Phone:413-577-5000
Practice Address - Fax:413-577-5440
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA48529207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA16901OtherHEALTH NEW ENGLAND
MA485296OtherCONNECTICARE
MA048529OtherTUFTS
MA5780131006OtherCIGNA
MA1130365OtherAETNA
MA187697OtherHEALTHSOURCE
MA690002OtherHARVARD PILGRIM
MAN51786OtherBCBSMA
MA690002OtherHARVARD PILGRIM