Provider Demographics
NPI:1750495974
Name:BEDFORD-LEXINGTON INTERNAL MEDICINE, PC
Entity Type:Organization
Organization Name:BEDFORD-LEXINGTON INTERNAL MEDICINE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NORMAN
Authorized Official - Middle Name:S
Authorized Official - Last Name:WEINBERG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:781-274-6274
Mailing Address - Street 1:450 BEDFORD ST
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02420-1535
Mailing Address - Country:US
Mailing Address - Phone:781-274-6274
Mailing Address - Fax:781-862-1472
Practice Address - Street 1:450 BEDFORD ST
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:MA
Practice Address - Zip Code:02420-1535
Practice Address - Country:US
Practice Address - Phone:781-274-6274
Practice Address - Fax:781-862-1472
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA9754440Medicaid
MA9754440Medicaid