Provider Demographics
NPI:1609857903
Name:LEB, LASZLO (MD)
Entity Type:Individual
Prefix:
First Name:LASZLO
Middle Name:
Last Name:LEB
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:630 PLANTATION ST
Mailing Address - Street 2:WOT 12TH FL ATTN: PHYSICIAN SERVICES
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01605-2038
Mailing Address - Country:US
Mailing Address - Phone:508-368-5529
Mailing Address - Fax:508-368-5530
Practice Address - Street 1:20 WORCESTER CENTER BLVD
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01608-1312
Practice Address - Country:US
Practice Address - Phone:508-368-3168
Practice Address - Fax:508-368-3166
Is Sole Proprietor?:No
Enumeration Date:2005-11-14
Last Update Date:2011-11-07
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Provider Licenses
StateLicense IDTaxonomies
MA40628207RH0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0000XAllopathic & Osteopathic PhysiciansInternal MedicineHematology
Provider Identifiers
StateIdentifier IDID TypeIssuer
784228OtherMVP HEALTH CARE
9900270OtherFALLON COMMUNITY HEALTH
N01713OtherBLUE CARE ELECT
040628OtherTUFTS HEALTH PLAN
N01713OtherMEDICARE B
04-2472266OtherPRIVATE HEALTHCARE SYSTEM
042472266OtherHEALTHCARE VALUE
1266084OtherCIGNA HEALTH PLAN
04-2472266OtherTHREE RIVERS
27530OtherHEALTHY SMART
AA3714OtherHARVARD PILGRIM
042472266OtherTRICARE CHAMPUS
4385559OtherAETNA US HEALTHCARE
042472266OtherONE HEALTH PLAN
1060864OtherFIRST HEALTH
830005042OtherRAILROAD MEDICARE
N01713OtherBLUE SHIELD INDEMNITY
27530OtherCHILDRENS MEDICALSECURITY
04-2472266OtherTHREE RIVERS
042472266OtherTRICARE CHAMPUS