Provider Demographics
NPI:1184683617
Name:LEE, DENNIS ELLIOTT (MD)
Entity Type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:ELLIOTT
Last Name:LEE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 WASHINGTON ST
Mailing Address - Street 2:SUITE 368
Mailing Address - City:NEWTON
Mailing Address - State:MA
Mailing Address - Zip Code:02462
Mailing Address - Country:US
Mailing Address - Phone:617-969-1227
Mailing Address - Fax:617-969-2676
Practice Address - Street 1:2000 WASHINGTON ST
Practice Address - Street 2:SUITE 368 GASTROENTEROLOGY HEALTH CARE ASSOCIATES
Practice Address - City:NEWTON
Practice Address - State:MA
Practice Address - Zip Code:02462
Practice Address - Country:US
Practice Address - Phone:617-969-1227
Practice Address - Fax:617-969-2676
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA51287207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAJ04534OtherBCBS MA
MA3002641Medicaid
MA703023OtherTUFTS HEALTH PLAN
MA3002641Medicaid
B76554Medicare UPIN