Provider Demographics
NPI:1114464666
Name:LESHEM, ERAN (MD)
Entity Type:Individual
Prefix:
First Name:ERAN
Middle Name:
Last Name:LESHEM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:ERAN
Other - Middle Name:DAVID
Other - Last Name:LESHEM - RUBINOW
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:185 PILGRIM RD
Mailing Address - Street 2:BAKER 4
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02215-5324
Mailing Address - Country:US
Mailing Address - Phone:617-667-8800
Mailing Address - Fax:
Practice Address - Street 1:185 PILGRIM RD
Practice Address - Street 2:BAKER 4
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02215-5324
Practice Address - Country:US
Practice Address - Phone:617-667-8800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-23
Last Update Date:2017-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program