Provider Demographics
NPI:1497773584
Name:LEVIN, BARRY LESTER (MD)
Entity Type:Individual
Prefix:DR
First Name:BARRY
Middle Name:LESTER
Last Name:LEVIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
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:
Mailing Address - Fax:
Practice Address - Street 1:SUITE 760
Practice Address - Street 2:131 ORNAC
Practice Address - City:CONCORD
Practice Address - State:MA
Practice Address - Zip Code:01743-4181
Practice Address - Country:US
Practice Address - Phone:978-341-0060
Practice Address - Fax:978-341-0063
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-17
Last Update Date:2012-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA520122084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAJ29249OtherMEDEX
MA6146511Medicaid
MA712959OtherTUFTS HEALTH PLAN
MA96741OtherFALLON COMMUNITY HEALTHCA
MA11029OtherHARVARD PILGRIM HEALTHCAR
MA1117362OtherAETNA
MA130024913OtherRAILROAD MEDICARE
MA6146511OtherE D S
MA2121133OtherCIGNA HEALTHCARE
MA11029OtherHARVARD FIRST SENIORITY
MA712959OtherTUFTS MEDICARE PREFERRED
MAJ29249OtherBLUE CROSS BLUE SHIELD
MA11029OtherHARVARD FIRST SENIORITY
MA6146511OtherE D S
MA11029OtherHARVARD PILGRIM HEALTHCAR