Provider Demographics
NPI:1780640383
Name:LAKRITZ, NEAL S (MD)
Entity Type:Individual
Prefix:DR
First Name:NEAL
Middle Name:S
Last Name:LAKRITZ
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Gender:M
Credentials:MD
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Mailing Address - Street 1:2150 MAIN STREET
Mailing Address - Street 2:SPRINGFIELD MEDICAL ASSOCIATES, INC.
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01104
Mailing Address - Country:US
Mailing Address - Phone:413-739-5676
Mailing Address - Fax:413-733-5860
Practice Address - Street 1:ENFIELD MEDICAL ASSOCIATES
Practice Address - Street 2:701 ENFIELD STREET
Practice Address - City:ENFIELD
Practice Address - State:CT
Practice Address - Zip Code:06082
Practice Address - Country:US
Practice Address - Phone:860-741-6058
Practice Address - Fax:413-733-5860
Is Sole Proprietor?:No
Enumeration Date:2006-04-22
Last Update Date:2022-10-18
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Provider Licenses
StateLicense IDTaxonomies
CT68197207R00000X, 207RA0401X
MA51339207R00000X, 207RA0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RA0401XAllopathic & Osteopathic PhysiciansInternal MedicineAddiction Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA6190979Medicaid
MA3139751Medicaid
MAA68244Medicare UPIN
MAY02262Medicare ID - Type Unspecified