Provider Demographics
NPI:1164577995
Name:BARRY L LEVIN MD
Entity Type:Organization
Organization Name:BARRY L LEVIN MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER OF PRACTICE
Authorized Official - Prefix:DR
Authorized Official - First Name:BARRY
Authorized Official - Middle Name:LESTER
Authorized Official - Last Name:LEVIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:978-341-0060
Mailing Address - Street 1:PO BOX 845039
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02284-5039
Mailing Address - Country:US
Mailing Address - Phone:978-341-0060
Mailing Address - Fax:978-341-0063
Practice Address - Street 1:131 ORNAC
Practice Address - Street 2:SUITE 760
Practice Address - City:CONCORD
Practice Address - State:MA
Practice Address - Zip Code:01742-4181
Practice Address - Country:US
Practice Address - Phone:978-341-0060
Practice Address - Fax:978-341-0063
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-24
Last Update Date:2008-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA52012174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA2121133OtherCIGNA HEALTHCARE
MA6146511OtherE D S
MA712959OtherTUFTS MEDICARE PREFERRED
MAM19056OtherBLUE CROSS BLUE SHIELD
MA130024913OtherRAILROAD MEDICARE
MA96741OtherFALLON
MA11029OtherHARVARD PILGRIM
MA1117362OtherAETNA
MA6146511Medicaid
MA712959OtherTUFTS HEALTH PLAN
MA712959OtherTUFTS HEALTH PLAN
MA11029OtherHARVARD PILGRIM
MAC89843Medicare UPIN